Wafer paper and ring-mounted polyglycolic acid sheet method for shielding artificial gastric floor

Kobayashi, Nobuya; Kobara, Hideki; Nishiyama, Noriko; Fujihara, Shintaro; Kozuka, Kazuhiro; Tada, Naoya; Matsui, Takanori; Chiyo, Taiga; Takata, Tadayuki; Fujita, Koji; Tani, Joji; Yachida, Tatsuo; Okano, Keiichi; Nakano, Daisuke; Nishiyama, Akira; Mori, Hideki; Masaki, Tsutomu

doi:10.1080/13645706.2020.1871370

Cited by 3 publications

(3 citation statements)

References 26 publications

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“…A novel device delivery station system (DDSS) is also being developed for rapid and tight PGA delivery and affixation [67]. In a recent single-arm study, Kobayashi and colleagues [47] proposed a wafer paper and ring-mounted PGA sheet (WaRP) method, which required 10.5 ± 6.7 min for fixation, the fastest to date.…”

Section: Discussionmentioning

confidence: 99%

“…Of the total, 54 proved potentially relevant for full-text review. Of these, 31 articles on the management of ESD-induced ulcers via endoscopic closure (hemoclips, endoclips, endoloop + endoclips, detachable snare + clips, OTSC + through-the-scope clips [TTSC], overstitch suturing, handsewn suturing) [31][32][33][34][35][36][37][38][39][40][41][42], tissue shielding methods (PGA sheets-based) [10,[43][44][45][46][47][48][49], and hemostatic powder/gel spray [18,19,[50][51][52][53][54][55][56][57][58], matched the selection criteria and were included in the systematic review. The key characteristics of each included study appear in Table 1.…”

Section: Identified Studies and Qualitymentioning

confidence: 99%

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Endoscopic Delivery of Polymers Reduces Delayed Bleeding after Gastric Endoscopic Submucosal Dissection: A Systematic Review and Meta-Analysis

et al. 2022

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New endoscopic approaches for the prevention of delayed bleeding (DB) after gastric endoscopic submucosal dissection (ESD) have been reported in recent years, and endoscopic delivery of biodegradable polymers for iatrogenic ulcer hemostasis and coverage has emerged as one of the most promising techniques for post-ESD management. However, the comparative efficacy of these techniques remains uncertain. We performed a systematic search of multiple databases up to May 2022 to identify studies reporting DB rates as outcomes in patients undergoing gastric ESD who were treated with subsequent endoscopic management, including endoscopic closure (clip-based methods and suturing), PGA sheet tissue shielding, and hemostatic powder/gel spray (including polymeric sealants and other adhesives). The risk ratios (RRs) of delayed bleeding in treatment groups and control groups were pooled, and the Bayesian framework was used to perform a network meta-analysis (NMA). Among these studies, 16 head-to-head comparisons that covered 2742 lesions were included in the NMA. Tissue shielding using PGA sheets significantly reduced the risk of DB by nearly two thirds in high-risk patients, while hemostatic spray systems, primarily polymer-based, reduced DB in low-risk patients nine-fold. Researchers should recognize the essential role of polymers in the management of ESD-induced ulcers, and develop and validate clinical application strategies for promising materials.

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Section: Discussionmentioning

confidence: 99%

Section: Identified Studies and Qualitymentioning

confidence: 99%

Endoscopic Delivery of Polymers Reduces Delayed Bleeding after Gastric Endoscopic Submucosal Dissection: A Systematic Review and Meta-Analysis

et al. 2022

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“…Shielding using polyglycolic acid (PGA) sheets and fibrin glue has been developed as a means of preventing post-ESD complications [ 9 ]; this includes the PGA sheet delivery method [ 10 - 14 ]. However, since there is insufficient evidence for the effectiveness of applying PGA sheets to prevent post-ESD gastric bleeding [ 15 , 16 ], further research is needed.…”

Section: Introductionmentioning

confidence: 99%

Comparison of endoscopic closure versus non-closure for post-gastric endoscopic submucosal dissection artificial floor in antithrombotic therapy: a propensity score-matched analysis

Kobayashia¹

2023

aog

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Background The management of delayed bleeding after gastric endoscopic submucosal dissection (ESD) is currently an important issue because of recent increases in the number of patients on antithrombotic therapy. Artificial ulcer closure has been shown to prevent delayed complications in the duodenum and colon. However, its effectiveness in cases involving the stomach remains unclear. In this study, we aimed to determine whether endoscopic closure reduces post-ESD bleeding in patients undergoing antithrombotic therapy. Methods We retrospectively analyzed 114 patients who had undergone gastric ESD while on antithrombotic therapy. The patients were allocated to one of 2 groups: a closure group (n=44) and a non-closure group (n=70). Endoscopic closure had been performed using multiple hemoclips or using the endoscopic ligation with O-ring closure method after coagulation of exposed vessels on the artificial floor. Propensity score matching resulted in 32 pairs of patients (closure vs. non-closure 32:32). The primary outcome was post-ESD bleeding. Results The post-ESD bleeding rate was significantly lower in the closure group (0%) than in the non-closure group (15.6%) (P=0.0264). There were no significant differences between the 2 groups regarding white blood cell count, C-reactive protein, maximum body temperature, or scores on a verbal rating scale that assesses the degree of abdominal pain. Conclusion Endoscopic closure may contribute to decreasing the incidence of post-ESD gastric bleeding in patients undergoing antithrombotic therapy.

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The stability of a novel synthetic peptide-type hemostatic material under digestive enzyme

Kubo

Kobayashi

Yamamoto

et al. 2022

Minimally Invasive Therapy & Allied Technologies

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Wafer paper and ring-mounted polyglycolic acid sheet method for shielding artificial gastric floor

Cited by 3 publications

References 26 publications

Endoscopic Delivery of Polymers Reduces Delayed Bleeding after Gastric Endoscopic Submucosal Dissection: A Systematic Review and Meta-Analysis

Endoscopic Delivery of Polymers Reduces Delayed Bleeding after Gastric Endoscopic Submucosal Dissection: A Systematic Review and Meta-Analysis

Comparison of endoscopic closure versus non-closure for post-gastric endoscopic submucosal dissection artificial floor in antithrombotic therapy: a propensity score-matched analysis

The stability of a novel synthetic peptide-type hemostatic material under digestive enzyme

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