A Prospective, Randomized Comparison of 10-Fr Versus 7-Fr Bipolar Electrocoagulation Catheter in Combination With Adrenaline Injection in The Endoscopic Treatment of Bleeding Peptic Ulcers

Paspatis, Gregorios A.; Charoniti, Ioanna; Papanikolaou, Nikolaos; Vardas, Emmanouil; Chlouverakis, Gregorios

doi:10.1111/j.1572-0241.2003.07691.x

Cited by 8 publications

(2 citation statements)

References 30 publications

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“…There are, however, data from other areas of the gastrointestinal tract to suggest that ulcer size is correlated to bleeding rate. 33,34 Our rate of bleeding after elective variceal band ligation (three bleeding episodes in a total of 86 sessions, or 3.5%) is similar to that previously reported by other groups. All three of the bleeding episodes were from postbanding ulcers, and all were in patients treated with placebo.…”

Section: Discussionsupporting

confidence: 88%

Pantoprazole reduces the size of postbanding ulcers after variceal band ligation: A randomized, controlled trial

et al. 2005

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Elective esophageal variceal ligation (EVL) is performed to decrease the risk of variceal hemorrhage. Side effects of EVL include hemorrhage, chest pain, dysphagia, and odynophagia. Because gastric acid may exacerbate postbanding ulcers and delay healing, proton pump inhibition may decrease side effects associated with EVL. The aim of this study was to assess the efficacy of pantoprazole, a proton pump inhibitor, as an adjunct to elective EVL. We performed a double-blinded, randomized, placebo-controlled trial of pantoprazole after elective EVL. Subjects in the pantoprazole arm received 40 mg pantoprazole intravenously after EVL followed by 40 mg oral pantoprazole for 9 days. Control subjects received intravenous and oral placebo. Subjects underwent upper endoscopy 10 to 14 days after banding. Primary outcomes included the size and number of ulcers and the subjects' reports of dysphagia, chest pain, and heartburn. Forty-four subjects were randomized: 42 completed the protocol. At follow-up endoscopy, the mean number of ulcers was similar in the two groups. However, the ulcers in the pantoprazole group were on average half as large as in the placebo group (37 mm 2 vs. 82 mm 2 , P < .01). Chest pain, dysphagia, and heartburn scores were not significantly different. Four subjects, all in the placebo group, had adverse outcomes, including 3 who bled from postbanding ulcers and 1 with sepsis. In conclusion, subjects receiving pantoprazole after elective EVL had significantly smaller postbanding ulcers on follow-up endoscopy than subjects receiving placebo. However, the total ulcer number and patient symptoms were not different between the groups. (HEPATOLOGY 2005;41: 588-594.)

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Section: Discussionsupporting

confidence: 88%

Pantoprazole reduces the size of postbanding ulcers after variceal band ligation: A randomized, controlled trial

et al. 2005

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“…Studies in which a combination of hemostatic methods would be used, are welcomed [3]. Moreover, based on data obtained from the management of bleeding peptic ulcers, endoscopic treatment combined with adrenaline injection and gold or heater probe coagulation offers significant advantages such as prevention of rebleeding, reducing the need for blood transfusion and operation [10]. The use of combined endoscopic treatment, with adrenaline injection and band ligation, in the management of postpolypectomy bleeding has been proposed for gastric polyps [11].…”

Section: Discussionmentioning

confidence: 98%

Combination of Adrenaline Injection and Detachable Snare Application as Haemostatic Preventive Measures, Before Polypectomy of Large Colonic Polyps in Children

et al. 2007

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Juvenile polyps are the most common type of polyps encountered in childhood, found approximately, in 1% of the pediatric population [1]. There is a male predominance [1] and the peak age of occurrence ranges between 2-6 years [1]. Painless rectal bleeding is the most common symptom, found in 90% of cases [1]. With the advent of the colonoscopy, it has been noticed that >50% of the children have >1 polyp and about 60% of the polyps are located proximal to the rectosigmoid [2]. Because juvenile polyps are usually pedunculated, colonoscopic removal is a common and safe practice [2]. Postpolypectomy bleeding is the most common complication of endoscopic polypectomy [3]. Several studies in adults have shown that the size of the polyp is a risk factor for postpolypectomy bleeding [4]. To minimize the risk of postpolypectomy bleeding, several new techniques have been proposed. These include application of detachable snares or endoclips, injections of adrenaline solutions, and several thermal modalities. We report 4 cases of children with large pedunculated colonic polyps, removed endoscopically, having received an adrenaline injection which was administered locally and the application of a detachable snare, to minimize the risk of postpolypectomy bleeding. Then polypectomy was performed using a standard snare

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Tools and Techniques for Gastrointestinal Hemostasis

Ahad

Mellinger

2013

Principles of Flexible Endoscopy for Surgeons

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A Prospective, Randomized Comparison of 10-Fr Versus 7-Fr Bipolar Electrocoagulation Catheter in Combination With Adrenaline Injection in The Endoscopic Treatment of Bleeding Peptic Ulcers

Cited by 8 publications

References 30 publications

Pantoprazole reduces the size of postbanding ulcers after variceal band ligation: A randomized, controlled trial

Pantoprazole reduces the size of postbanding ulcers after variceal band ligation: A randomized, controlled trial

Combination of Adrenaline Injection and Detachable Snare Application as Haemostatic Preventive Measures, Before Polypectomy of Large Colonic Polyps in Children

Tools and Techniques for Gastrointestinal Hemostasis

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