Use of PGA sheets and fibrin glue to prevent post-ESD bleeding

Dr TsujiYosuke Tsuji, MD, PhD, Mitsuhiro Fujishiro, MD, PhD, and Kazuhiko Koike, MD, PhD from Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo in Tokyo, Japan discuss this Original Article “Polyglycolic acid sheets and fibrin glue decrease the risk of bleeding after endoscopic submucosal dissection of gastric neoplasms (with video).”

Polyglycolic acid (PGA) is an absorbent suture reinforcement material, and PGA sheets and fibrin glue have been applied to several surgical fields: video-assisted major lung resection, partial glossectomy, pancreaticoduodenectomy, and gastrectomy. In this study, we investigated whether PGA sheets and fibrin glue could decrease the risk of bleeding after gastric endoscopic submucosal dissection (ESD).

Bleeding after gastric ESD is still a major concern, but there have been no other methods for preventing this adverse event except proton pump inhibitor use or preventive coagulation of visible vessels in the resection area after ESD. Developing a new effective method is a pressing issue.

Figure 1

In this nonrandomized trial with historical control subjects, we demonstrated that endoscopic tissue shielding method with PGA sheets and fibrin glue could prevent bleeding after gastric ESD for high-risk patients. Developing an easy delivery technique of PGA sheets is important, and a large-scale randomized controlled trial is necessary in the future.

Read the abstract for this article online.

The information presented in Endoscopedia reflects the opinions of the authors and does not represent the position of the American Society for Gastrointestinal Endoscopy (ASGE). ASGE expressly disclaims any warranties or guarantees, expressed or implied, and is not liable for damages of any kind in connection with the material, information, or procedures set forth.

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