Endoscopic management of postoperative ileocolonic anastomotic bleeding by using water submersion

Gor, Niraj; Patil, Abhitabh

doi:10.1016/j.gie.2011.01.033

Cited by 5 publications

(5 citation statements)

References 6 publications

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“…In the literature, there are fewer than 10 reported patients presenting with severe hemorrhage after ileocolic anastomosis. These patients were treated either endoscopically or by resecting and refashioning the anastomosis [6,7,22,23]. In the present study, selective angiography was performed in three patients after contrast extravasation was shown by CT.…”

Section: Discussionmentioning

confidence: 99%

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Incidence and management of anastomotic bleeding after ileocolic anastomosis

et al. 2013

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Section: Discussionmentioning

confidence: 99%

“…Best practice to locate the site of bleeding and therapeutic manoeuvres is still under discussion. The latter includes reoperation with anastomotic refashioning, angiographic embolization, locally applied vasoactive substances, endoscopic therapy and conservative treatment with blood transfusion .…”

Section: Introductionmentioning

confidence: 99%

Incidence and management of anastomotic bleeding after ileocolic anastomosis

et al. 2013

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“…During endoscopy for gastrointestinal bleeding, it is often difficult to secure the visual field due to massive bleeding in the lumen. Although the water immersion technique has been used 1 2 3 , it often fails to secure the visual field, because injected/infused water is rapidly mixed with blood and residue. Although endoscopic resection with the water (water or saline) immersion technique has become popular 4 5 6 7 , it is difficult to secure the visual field in case of intraprocedural bleeding 7 .…”

Section: Introductionmentioning

confidence: 99%

Development of a gel dedicated to gel immersion endoscopy

et al. 2021

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Backgrounds and study aims Gel immersion endoscopy is a novel technique to secure the visual field during endoscopy. The aim of this study was to develop a dedicated gel for this technique. Methods To identify appropriate viscoelasticity and electrical conductivity, various gels were examined. Based on these results, the dedicated gel “OPF-203” was developed. Efficacy and safety of OPF-203 were evaluated in a porcine model. Results In vitro experiments showed that a viscosity of 230 to 1900 mPa·s, loss tangent (tanδ) ≤ 0.6, and hardness of 240 to 540 N/cm2 were suitable. Ex vivo experiments showed electrical conductivity ≤ 220 μS/cm is appropriate. In vivo experiments using gastrointestinal bleeding showed that OPF-203 provided clear visualization compared to water. After electrocoagulation of gastric mucosa in OPF-203, severe coagulative necrosis was not observed in the muscularis but limited to the mucosa. Conclusions OPF-203 is useful for gel immersion endoscopy.

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“…Although endoscopy in a perforated gastrointestinal tract should be avoided, gel immersion endoscopy facilitates maintaining the luminal pressure lower than gas insufflation and water infusion/immersion. This benefit of gel immersion endoscopy may be useful in a variety of situations where low internal pressure endoscopy is desirable, such as postoperative anastomotic bleeding 1 2 and endoscopic detorsion of a sigmoid volvulus 9 .…”

Section: Discussionmentioning

confidence: 99%

“…During endoscopy, especially in patients with gastrointestinal bleeding, it is often difficult to secure the visual field. Although water immersion techniques are sometimes used to mitigate this situation 1 2 3 , maintenance of the visual field is often difficult because the infused/injected water rapidly mixes with any luminal blood and/or residue. Poor preparation before colonoscopy also makes it difficult to secure the visual field when using water immersion or water exchange techniques.…”

Section: Introductionmentioning

confidence: 99%