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Application of a novel self-assembling peptide to prevent hemorrhage after EMR, a feasibility and safety study

机译:新型自组装肽的应用,防止EMR后出血,可行性和安全研究

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Background A novel self-assembling peptide (SAP) can be applied to the post-endoscopic mucosal resection (EMR) defect to treat oozing bleedings. It has been suggested to stimulate early healing of damaged vessels. We hypothesized that SAP application could prevent delayed bleeding (DB) after EMR and performed a prospective cohort study to determine feasibility and safety. Methods A total of 48 consecutive patients who underwent EMR between June 2018 and August 2019 for large lesions in the esophagus, duodenum (> 1 cm) or colorectum (> 2 cm) were treated with adjuvant SAP application. Duration and ease of SAP application were measured, as well as DB outcome. Results The EMR defects of 48 patients were treated with SAP; 17 in the esophagus, 13 in the duodenum and 18 in the colorectum. SAP was easy to apply on the EMR defect with a median duration of 2.0 min. A dose of 3 cc was generally enough to cover a defect between 10 and 50 mm. An exploratory analysis of the prophylactic ability of SAP showed that 15.9% of patients (7/44) treated with SAP still had a DB, mostly in the duodenum (4/11). No adverse events related to gel exposure were reported. Conclusions SAP application after EMR was found to be feasible and safe, and did not delay the procedure; however, DB was still relatively common. Future comparative studies are needed to evaluate whether SAP is able to reduce DB after EMR, particularly for lesions with an increased bleeding risk, such as in the duodenum.
机译:背景一种新的自组装肽(SAP)可应用于内镜下黏膜切除术(EMR)后缺损治疗渗出性出血。有人建议刺激受损血管的早期愈合。我们假设SAP应用可以预防EMR后的延迟性出血(DB),并进行了前瞻性队列研究,以确定其可行性和安全性。方法在2018年6月至2019年8月期间,共有48例因食管、十二指肠(>1cm)或结肠(>2cm)大病变而接受EMR的患者接受了辅助性SAP治疗。测量SAP应用程序的持续时间和易用性,以及数据库结果。结果48例患者的EMR缺损采用SAP治疗;食管17例,十二指肠13例,结肠18例。SAP易于应用于EMR缺陷,平均持续时间为2.0分钟。3 cc的剂量通常足以覆盖10至50 mm的缺陷。对SAP预防能力的探索性分析显示,15.9%(7/44)接受SAP治疗的患者仍有DB,主要位于十二指肠(4/11)。未报告与凝胶暴露相关的不良事件。结论EMR术后应用SAP是可行和安全的,且不会延迟手术;然而,DB仍然相对常见。需要进一步的对比研究来评估SAP是否能够在EMR后降低DB,尤其是对于出血风险增加的病变,如十二指肠。

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