Efficacy of innovative polyglycolic acid sheet device delivery station system: a randomized prospective study

被引:9
|
作者
Mori, Hirohito [1 ,3 ]
Guan, Yu [2 ]
Kobara, Hideki [1 ]
Kobayashi, Seiki [3 ]
Nishiyama, Noriko [1 ]
Kobayashi, Nobuya [1 ]
Masaki, Tsutomu [1 ]
机构
[1] Kagawa Univ, Fac Med, Dept Gastroenterol & Neurol, Kita Ku, 1750-1 Ikenobe, Miki, Kagawa 7610793, Japan
[2] Kagawa Univ, Dept Pharmacol, Kita Ku, 1750-1 Ikenobe, Miki, Kagawa 7610793, Japan
[3] Ehime Rosai Hosp, Dept Gastroenterol Surg, 13-27 Minamikomatsubara, Niihama, Ehime 7928550, Japan
关键词
Delivery of polyglycolic acid sheet; Coating area per minute; Post-endoscopic submucosal dissection bleeding; Device delivery station system; ENDOSCOPIC SUBMUCOSAL DISSECTION; PREVENT ESOPHAGEAL STRICTURE; TISSUE SHIELDING METHOD; FIBRIN GLUE; DELAYED PERFORATION; STEROID INJECTION; GASTRIC NEOPLASMS; RISK-FACTORS; CANCER; ULCER;
D O I
10.1007/s00464-017-6019-6
中图分类号
R61 [外科手术学];
学科分类号
摘要
Although there have been several reports of treating large post-endoscopic submucosal dissection (ESD) ulcers by covering them with a polyglycolic acid sheet (PGAs), this approach presents problems regarding PGAs delivery. This study assessed the usefulness of a device delivery station system (DDSS) to evaluate the appropriate and rapid PGAs coating method with DDSS. Thirty-nine of 41 patients who were diagnosed with early gastric cancer over 20 mm in diameter and pathologically diagnosed with well-differentiated adenocarcinoma were randomly allocated to the following two groups according to delivery method: the conventional PGAs delivery group (C group) (n = 19) and the new DDSS group (DDSS group) (n = 20). The primary outcome was the coating area per minute in the C group and DDSS group (cm(2)/min). There were significant differences in the coating time (min), with values of 34.1 (15.0-60.7) vs. 16.85 (11.5-27.2) min for the C group and DDSS group, respectively (p = 0.001). There was also a significant difference in coating area per minute, with values of 0.261 (0.02-1.00) and 0.96 (0.173-2.06) cm(2)/min for the C group and DDSS group, respectively (p = 0.001). There were four cases of post-ESD bleeding (1-7 days after ESD) in the C group compared with 0 in the DDSS group, which represented a significant difference (p = 0.030). The DDSS was very useful for rapidly delivering and tightly attaching a PGAs to control post-ESD bleeding. University Hospital Medical Network (UMIN) 000026377.
引用
收藏
页码:3076 / 3086
页数:11
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