Endoscopic management of bleeding gastrointestinal tumors

Ofosu, Andrew; Ramai, Daryl; Latson, Will; Adler, Douglas G.

doi:10.20524/aog.2019.0391

Cited by 19 publications

(20 citation statements)

References 49 publications

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“…Tumor related gastrointestinal bleeding (GIB) is not a rare condition and is responsible for up to 5% of GI bleeding cases [ 1 – 3 ]. GIB related tumors occur in the settings of primary gastrointestinal (GI) tumor, metastatic disease to the GI tract, or locally invasive tumor [ 4 ], and are commonly treated endoscopically by injection or using thermal or mechanical devices [ 5 ]. However, the endoscopic management of tumor bleeding is often clinically challenging due to poor patient clinical status and difficulties associated with the accessibility and extent of bleeding lesions.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of a novel hemostatic adhesive powder in patients with upper gastrointestinal tumor bleeding

et al. 2021

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Background Gastrointestinal tumor bleeding remains a clinical challenge because it is difficult to treat with conventional endoscopic hemostatic options. Recently, an endoscopic hemostatic powder (UI-EWD) was developed and reported to provide effective control of upper gastrointestinal bleeding. The aim of current study was to evaluate the feasibility and efficacy of this novel hemostatic powder in tumor bleeding. Methods A total of 41 consecutive patients with upper gastrointestinal tumor bleeding were included. UI-EWD was applied in all patients as an auxiliary hemostatic method as a salvage therapy or monotherapy during endoscopic treatment. Hemostasis success rates, adverse event related to UI-EWD, and rates of re-bleeding were evaluated. Results In all cases, UI-EWD application was successful at tumor bleeding sites. Immediate hemostasis occurred in 40/41 (97.5%) patients, and re-bleeding within 28 days occurred in 10 of 40 (22.5%) patients that achieved initial hemostasis. The success rate of immediate hemostasis for UI-EWD monotherapy was 100% (23/23). The re-bleeding rate at 28 days after UI-EWD monotherapy was 26.1% (6/23). No adverse events associated with UI-EWD application were encountered. Conclusions The success rate of UI-EWD for immediate hemostasis in cases of GI tumor bleeding was excellent and UI-EWD produced promising results with respect to the prevention of re-bleeding. Based on these results, we suggest that UI-EWD be considered an effective salvage therapy or even monotherapy for GI tumor bleeding.

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Section: Introductionmentioning

confidence: 99%

Efficacy of a novel hemostatic adhesive powder in patients with upper gastrointestinal tumor bleeding

et al. 2021

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“…Currently, there is no gold standard treatment for GIB from GI malignancy. Despite its frequent use in clinical practice, APC is associated with temporary efficacy and high recurrent bleeding rates in GIB due to malignancy [19]. Data regarding the use of HP in patients with GIB caused by malignancy refer mainly to retrospective series and to few prospective studies including small series of patients [20,21].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of hemostatic powders as monotherapy or rescue therapy in gastrointestinal bleeding related to neoplastic or non-neoplastic lesions

Paoluzi

Cardamone

Aucello³

et al. 2021

Scandinavian Journal of Gastroenterology

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BACKGROUND Hemostatic powder (HP) in gastrointestinal bleeding (GIB) is mainly used as rescue therapy after failure of conventional hemostatic procedures (CHP).AIM To define the best field of application and the efficacy of HP as first choice monotherapy or rescue therapy. METHODSWe compared the efficacy of HP monotherapy, HP rescue therapy, and CHP in the management of active GIB due to neoplastic and non-neoplastic lesions.RESULTS A total of 108 patients, 43 treated with HP as either first choice or rescue therapy and 65 with CHP, were included in the study. The most frequent sources of bleeding were peptic ulcer and malignancy. Immediate hemostasis rates were: HP monotherapy = 100% in peptic ulcer and 100% in malignancy; HP rescue therapy = 93.2% in peptic ulcer and 85.7% in malignancy; CHP = 77.9% in peptic ulcer and 41.7 in malignancy. Definitive hemostasis rates were: HP monotherapy = 50% in peptic ulcer and 45.5% in malignancy; HP rescue therapy = 73.3% in peptic ulcer and 85.7% in malignancy; CHP = 69.1% in peptic ulcer and 33.3% in malignancy. No difference was found in terms of additional intervention between the three groups.CONCLUSIONS HP is highly effective as monotherapy and rescue therapy in GIB. GIB related to malignancy may be the best field of application of HP, but confirmatory studies are necessary.

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“…Another challenge associated with upper GI tract tumors is hemorrhage, which accounts for almost 1%–5%. 7 Endoscopic intervention is considered as a first-line treatment in achieving hemostasis, which comprises local injections of adrenaline, application of heater probe, argon plasma coagulation, radiofrequency ablation, cryotherapy and hemospray. Despite the variety of treatment modalities, re-bleeding is common.…”

Section: Discussionmentioning

confidence: 99%

Salvage therapy of bleeding esophageal tumor by fully covered self-expandable metallic stent: A case report

Bilal

Saeed

Siddique

et al. 2021

SAGE Open Medical Case Reports

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The role of self-expandable metallic stents is gradually evolving for a diverse group of benign and malignant gastrointestinal tract problems, with luminal obstruction being by far the most common. Although its role in refractory variceal bleeding is well established, it has rarely been tried for tumor-related bleeding, with only a few case reports in this regard. We share our experience of successfully controlling esophageal tumor–related bleeding with the use of a fully covered self-expandable metallic stent. A 58-year-old woman with irresectable distal esophageal cancer, presented with hematemesis. Esophago-gastro-duodenoscopy revealed an obstructing esophageal tumor with diffuse oozing of blood. This was unamenable to local injection of adrenaline and hemospray; therefore, a temporary self-expandable metallic stent was parked to create a tamponade effect. This successfully stopped bleeding and the patient remained asymptomatic till discharge. However, she was lost to follow-up, and therefore, the stent was removed after a period of 5 months instead of 2 weeks.

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Endoscopic management of bleeding gastrointestinal tumors

Cited by 19 publications

References 49 publications

Efficacy of a novel hemostatic adhesive powder in patients with upper gastrointestinal tumor bleeding

Efficacy of a novel hemostatic adhesive powder in patients with upper gastrointestinal tumor bleeding

Efficacy of hemostatic powders as monotherapy or rescue therapy in gastrointestinal bleeding related to neoplastic or non-neoplastic lesions

Salvage therapy of bleeding esophageal tumor by fully covered self-expandable metallic stent: A case report

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