Endoscopic injection therapy for nonvariceal upper gastrointestinal hemorrhage—Is it too good to be true?

Schuman, Bernard M.

doi:10.1016/s0016-5107(87)71528-4

Cited by 11 publications

(5 citation statements)

References 7 publications

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“…'22-28 Some questions have been raised, however, about injection therapy. '2 33 The detailed sites of bleeders were not mentioned,22 27 and the number of massive haemorrhages reported was small.t222426 Therefore, a randomised controlled trial has been needed to evaluate the haemostatic effect of injection therapy.2633 3 In our series massive haemorrhage was apparent in most patients. Seventy eight (56 9%) patients were in shock at the time of entry to the trial.…”

Section: Discussionmentioning

confidence: 83%

Heat probe thermocoagulation and pure alcohol injection in massive peptic ulcer haemorrhage: a prospective, randomised controlled trial.

Lin

Lee

Kang

et al. 1990

Gut

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We conducted a prospective randomised controlled trial of 137 patients with massive peptic ulcer haemorrhage over a period of 12 months to compare the haemostatic effects of endoscopic heat probe thermocoagulation and pure alcohol injection. Seventy eight patients (56 9%) were in shock at the time ofrandomisation to the trial. The age, sex, number of patients in shock, haemoglobin value at the time of entry to the trial, number of patients with severe medical iliness, location of bleeders, and stigmata of recent haemorrhage were comparable among the heat probe, pure alcohol, and control groups. The initial haemostatic effect of the heat probe was better than that of the pure alcohol injection (44 of 45 v 31 of 46, p=00004). The ultimate haemostasis achieved by the heat probe group (41 of 45) was better than that of the pure alcohol group (31 of 46, p=0012) and ofcontrols (24 of 46, p=00001). The duration of hospital stay was shorter for patients in the heat probe group than for the control group (6-2 days v 13-8 days, p<005). The incidence of emergency surgery was less for the heat probe than the control group (three of 45 v 12 of 46, p=0027).' The mortality rate was less in the heat probe than in the control group (one of 45 v seven of 46, p=0031). We suggest that heat probe thermocoagulation should be the first treatment of choice for arrest of massive peptic ulcer haemorrhage.

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Section: Discussionmentioning

confidence: 83%

Heat probe thermocoagulation and pure alcohol injection in massive peptic ulcer haemorrhage: a prospective, randomised controlled trial.

Lin

Lee

Kang

et al. 1990

Gut

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“…Recently, however, the endoscope has been successfully used for therapeutic interventional purposes in patients with GI bleeding intractable to medical management [2,3,[6][7][8][9][10][11][12][13][14][15][16]. However, it is important to select the patients who need such procedures since in around 80% of the patients, the bleeding stops spontaneously [18,19].…”

Section: Discussionmentioning

confidence: 99%

“…Multiple reports achieved a high success rate in permanent hemostasis by injecting non-variceal UGI bleeders with various materials (7,(9)(10)(11)(12)(13)(14)(15).…”

Section: Discussionmentioning

confidence: 99%

“…i.e., heater probe, multipolar electrocoagulators (e.g.) BICAP and ND-Yag laser [7][8][9]; and 2. endoscopic injection therapy (EIT) [9][10][11].…”

mentioning

confidence: 99%

“…Different materials have been used in EIT with excellent results, e.g., absolute ethanol, hypertonic saline, epinephrine, polidacanol, etc., either alone or combined with other substance(s) [11][12][13][14][15][16]. We report on our experience in using EIT to achieve permanent hemostasis in our non-variceal UGI bleeding patients in whom the intensive medical therapy proved to be ineffective.…”

mentioning

confidence: 99%

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