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Efficacy of hemostatic gel for perioperative bleeding and prevention of delayed bleeding of cold snare polypectomy under anticoagulant
Background and Aim A hemostatic gel, PuraStat (3‐D Matrix, Tokyo, Japan), is used for various gastrointestinal hemostasis. In this study, we analyzed the efficacy of PuraStat for perioperative bleeding (POB) and prevention of delayed bleeding (DB) to colorectal cold snare polypectomy (CSP) with cont...
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| Published in: | JGH open 2024-01, Vol.8 (1), p.e13029-n/a |
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| creator | Yoshida, Naohisa Dohi, Osamu Inagaki, Yoshikazu Tomita, Yuri Hashimoto, Hikaru Kobayashi, Reo Inoue, Ken Hirose, Ryohei Morimoto, Yasutaka Inada, Yutaka Murakami, Takaaki Itoh, Yoshito |
| description | Background and Aim
A hemostatic gel, PuraStat (3‐D Matrix, Tokyo, Japan), is used for various gastrointestinal hemostasis. In this study, we analyzed the efficacy of PuraStat for perioperative bleeding (POB) and prevention of delayed bleeding (DB) to colorectal cold snare polypectomy (CSP) with continuous anticoagulant.
Methods
This was a single‐center, retrospective study. Subjects were lesions of 2–9 mm under continuous anticoagulant from 2021 to 2023 and treated with PuraStat for POB. The definition of POB was bleeding which did not stop spontaneously by 1.0–1.5 min after resection and needed hemostasis. Successful hemostasis was defined as cessation of bleeding within 1.0–1.5 min after spraying PuraStat and the rate of it and risk factors of POB were analyzed. For comparison, cases receiving previous CSP without PuraStat were extracted from all cases with CSP (2018‐2021), and POB and DB rate (DBR) were analyzed after propensity score matching.
Results
One hundred twenty‐two lesions (91: direct oral anticoagulant (DOAC), 31: warfarin) with anticoagulant were analyzed and the rate of successful hemostasis with PuraStat was 92.6% (DOAC/warfarin: 93.4%/80.6%, P = 0.01). The rate of DB was 0.0%. Multivariate analysis showed that significant risk factors about unsuccessful hemostasis for POB with PuraStat were lesion size 8–9 mm (P |
| doi_str_mv | 10.1002/jgh3.13029 |
| format | article |
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A hemostatic gel, PuraStat (3‐D Matrix, Tokyo, Japan), is used for various gastrointestinal hemostasis. In this study, we analyzed the efficacy of PuraStat for perioperative bleeding (POB) and prevention of delayed bleeding (DB) to colorectal cold snare polypectomy (CSP) with continuous anticoagulant.
Methods
This was a single‐center, retrospective study. Subjects were lesions of 2–9 mm under continuous anticoagulant from 2021 to 2023 and treated with PuraStat for POB. The definition of POB was bleeding which did not stop spontaneously by 1.0–1.5 min after resection and needed hemostasis. Successful hemostasis was defined as cessation of bleeding within 1.0–1.5 min after spraying PuraStat and the rate of it and risk factors of POB were analyzed. For comparison, cases receiving previous CSP without PuraStat were extracted from all cases with CSP (2018‐2021), and POB and DB rate (DBR) were analyzed after propensity score matching.
Results
One hundred twenty‐two lesions (91: direct oral anticoagulant (DOAC), 31: warfarin) with anticoagulant were analyzed and the rate of successful hemostasis with PuraStat was 92.6% (DOAC/warfarin: 93.4%/80.6%, P = 0.01). The rate of DB was 0.0%. Multivariate analysis showed that significant risk factors about unsuccessful hemostasis for POB with PuraStat were lesion size 8–9 mm (P < 0.01), warfarin (P = 0.01), and combination of antiplatelet (P = 0.01). Regarding the comparison about CSP with/without PuraStat, the clipping rate and DBR were 8.5%/94.9% (P < 0.01) and 0%/1.7% (P = 1.0).
Conclusion
The effects of PuraStat for POB and DB in colorectal CSP with continuous anticoagulant were acceptable.
In this study, we analyzed 122 cases with colorectal cold snare polypectomy (CSP) with continuous anticoagulant (91 cases: direct oral anticoagulant, 31 cases: warfarin) treated with a hemostatic gel, PuraStat. The rates of successful hemostasis and delayed bleeding were 92.6% and 0.0%, respectively. The rate of clipping after CSP was reduced to 7.4%.</description><identifier>ISSN: 2397-9070</identifier><identifier>EISSN: 2397-9070</identifier><identifier>DOI: 10.1002/jgh3.13029</identifier><identifier>PMID: 38268964</identifier><language>eng</language><publisher>Melbourne: Wiley Publishing Asia Pty Ltd</publisher><subject>Anticoagulants ; Cardiac arrhythmia ; Cardiovascular disease ; Catheters ; Cold ; cold snare polypectomy ; Colonoscopy ; colorectal polyps ; delayed bleeding ; Endoscopy ; Esophagus ; Hydrogels ; Morphology ; Original ; perioperative bleeding ; Polyps ; Prevention ; Risk factors ; Thromboembolism ; Tumors ; Ulcers</subject><ispartof>JGH open, 2024-01, Vol.8 (1), p.e13029-n/a</ispartof><rights>2024 The Authors. published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.</rights><rights>2024 The Authors. JGH Open published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.</rights><rights>2024. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c5959-ab7eb1e3d908e16cfad2a5f0772d91b592a26b493e8102cee9a414edd042ac443</cites><orcidid>0000-0001-6167-9705 ; 0000-0002-7429-705X ; 0000-0002-3434-8107 ; 0000-0002-0910-6915</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2919263094/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2919263094?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,11541,25731,27901,27902,36989,36990,44566,46027,46451,53766,53768,74869</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38268964$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yoshida, Naohisa</creatorcontrib><creatorcontrib>Dohi, Osamu</creatorcontrib><creatorcontrib>Inagaki, Yoshikazu</creatorcontrib><creatorcontrib>Tomita, Yuri</creatorcontrib><creatorcontrib>Hashimoto, Hikaru</creatorcontrib><creatorcontrib>Kobayashi, Reo</creatorcontrib><creatorcontrib>Inoue, Ken</creatorcontrib><creatorcontrib>Hirose, Ryohei</creatorcontrib><creatorcontrib>Morimoto, Yasutaka</creatorcontrib><creatorcontrib>Inada, Yutaka</creatorcontrib><creatorcontrib>Murakami, Takaaki</creatorcontrib><creatorcontrib>Itoh, Yoshito</creatorcontrib><title>Efficacy of hemostatic gel for perioperative bleeding and prevention of delayed bleeding of cold snare polypectomy under anticoagulant</title><title>JGH open</title><addtitle>JGH Open</addtitle><description>Background and Aim
A hemostatic gel, PuraStat (3‐D Matrix, Tokyo, Japan), is used for various gastrointestinal hemostasis. In this study, we analyzed the efficacy of PuraStat for perioperative bleeding (POB) and prevention of delayed bleeding (DB) to colorectal cold snare polypectomy (CSP) with continuous anticoagulant.
Methods
This was a single‐center, retrospective study. Subjects were lesions of 2–9 mm under continuous anticoagulant from 2021 to 2023 and treated with PuraStat for POB. The definition of POB was bleeding which did not stop spontaneously by 1.0–1.5 min after resection and needed hemostasis. Successful hemostasis was defined as cessation of bleeding within 1.0–1.5 min after spraying PuraStat and the rate of it and risk factors of POB were analyzed. For comparison, cases receiving previous CSP without PuraStat were extracted from all cases with CSP (2018‐2021), and POB and DB rate (DBR) were analyzed after propensity score matching.
Results
One hundred twenty‐two lesions (91: direct oral anticoagulant (DOAC), 31: warfarin) with anticoagulant were analyzed and the rate of successful hemostasis with PuraStat was 92.6% (DOAC/warfarin: 93.4%/80.6%, P = 0.01). The rate of DB was 0.0%. Multivariate analysis showed that significant risk factors about unsuccessful hemostasis for POB with PuraStat were lesion size 8–9 mm (P < 0.01), warfarin (P = 0.01), and combination of antiplatelet (P = 0.01). Regarding the comparison about CSP with/without PuraStat, the clipping rate and DBR were 8.5%/94.9% (P < 0.01) and 0%/1.7% (P = 1.0).
Conclusion
The effects of PuraStat for POB and DB in colorectal CSP with continuous anticoagulant were acceptable.
In this study, we analyzed 122 cases with colorectal cold snare polypectomy (CSP) with continuous anticoagulant (91 cases: direct oral anticoagulant, 31 cases: warfarin) treated with a hemostatic gel, PuraStat. The rates of successful hemostasis and delayed bleeding were 92.6% and 0.0%, respectively. The rate of clipping after CSP was reduced to 7.4%.</description><subject>Anticoagulants</subject><subject>Cardiac arrhythmia</subject><subject>Cardiovascular disease</subject><subject>Catheters</subject><subject>Cold</subject><subject>cold snare polypectomy</subject><subject>Colonoscopy</subject><subject>colorectal polyps</subject><subject>delayed bleeding</subject><subject>Endoscopy</subject><subject>Esophagus</subject><subject>Hydrogels</subject><subject>Morphology</subject><subject>Original</subject><subject>perioperative bleeding</subject><subject>Polyps</subject><subject>Prevention</subject><subject>Risk factors</subject><subject>Thromboembolism</subject><subject>Tumors</subject><subject>Ulcers</subject><issn>2397-9070</issn><issn>2397-9070</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNp9ks1u1DAQgCMEolXphQdAlrggpC3jvyQ-IVT1D1XiAmfLsSfZrLxxcJJFeQGeG6dpS8uBiz0af_48Hk2WvaVwRgHYp12z5WeUA1MvsmPGVbFRUMDLJ_FRdjoMOwCgZaEkz19nR7xkealycZz9vqjr1ho7k1CTLe7DMJqxtaRBT-oQSY-xDWlJyQOSyiO6tmuI6RzpIx6wG9vQLXcdejOj-4uknA3ekaEzEUkf_NyjHcN-JlPnMCZFeieYZvIpepO9qo0f8PR-P8l-XF58P7_e3H67ujn_cruxUkm1MVWBFUXuFJRIc1sbx4ysoSiYU7SSihmWV0JxLCkwi6iMoAKdA8GMFYKfZDer1wWz031s9ybOOphW3yVCbLSJqS6PmpasZKzIIQcmTF5XKIEZEEKCcKJiyfV5dfVTtUdnUy-i8c-kz0-6dqubcNAUSpCilMnw4d4Qw88Jh1Hv28GiTx3BMA2aKVpKymWuEvr-H3QXptilXi2UYjkHtXzv40rZGIYhYv1YDQW9jItexkXfjUuC3z2t_xF9GI4E0BX41Xqc_6PSX6-u-Sr9A5P5y7w</recordid><startdate>202401</startdate><enddate>202401</enddate><creator>Yoshida, Naohisa</creator><creator>Dohi, Osamu</creator><creator>Inagaki, Yoshikazu</creator><creator>Tomita, Yuri</creator><creator>Hashimoto, Hikaru</creator><creator>Kobayashi, Reo</creator><creator>Inoue, Ken</creator><creator>Hirose, Ryohei</creator><creator>Morimoto, Yasutaka</creator><creator>Inada, Yutaka</creator><creator>Murakami, Takaaki</creator><creator>Itoh, Yoshito</creator><general>Wiley Publishing Asia Pty Ltd</general><general>John Wiley & Sons, Inc</general><general>Wiley</general><scope>24P</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0001-6167-9705</orcidid><orcidid>https://orcid.org/0000-0002-7429-705X</orcidid><orcidid>https://orcid.org/0000-0002-3434-8107</orcidid><orcidid>https://orcid.org/0000-0002-0910-6915</orcidid></search><sort><creationdate>202401</creationdate><title>Efficacy of hemostatic gel for perioperative bleeding and prevention of delayed bleeding of cold snare polypectomy under anticoagulant</title><author>Yoshida, Naohisa ; Dohi, Osamu ; Inagaki, Yoshikazu ; Tomita, Yuri ; Hashimoto, Hikaru ; Kobayashi, Reo ; Inoue, Ken ; Hirose, Ryohei ; Morimoto, Yasutaka ; Inada, Yutaka ; Murakami, Takaaki ; Itoh, Yoshito</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5959-ab7eb1e3d908e16cfad2a5f0772d91b592a26b493e8102cee9a414edd042ac443</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Anticoagulants</topic><topic>Cardiac arrhythmia</topic><topic>Cardiovascular disease</topic><topic>Catheters</topic><topic>Cold</topic><topic>cold snare polypectomy</topic><topic>Colonoscopy</topic><topic>colorectal polyps</topic><topic>delayed bleeding</topic><topic>Endoscopy</topic><topic>Esophagus</topic><topic>Hydrogels</topic><topic>Morphology</topic><topic>Original</topic><topic>perioperative bleeding</topic><topic>Polyps</topic><topic>Prevention</topic><topic>Risk factors</topic><topic>Thromboembolism</topic><topic>Tumors</topic><topic>Ulcers</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yoshida, Naohisa</creatorcontrib><creatorcontrib>Dohi, Osamu</creatorcontrib><creatorcontrib>Inagaki, Yoshikazu</creatorcontrib><creatorcontrib>Tomita, Yuri</creatorcontrib><creatorcontrib>Hashimoto, Hikaru</creatorcontrib><creatorcontrib>Kobayashi, Reo</creatorcontrib><creatorcontrib>Inoue, Ken</creatorcontrib><creatorcontrib>Hirose, Ryohei</creatorcontrib><creatorcontrib>Morimoto, Yasutaka</creatorcontrib><creatorcontrib>Inada, Yutaka</creatorcontrib><creatorcontrib>Murakami, Takaaki</creatorcontrib><creatorcontrib>Itoh, Yoshito</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Proquest Health & Medical Complete</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>Directory of Open Access Journals</collection><jtitle>JGH open</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yoshida, Naohisa</au><au>Dohi, Osamu</au><au>Inagaki, Yoshikazu</au><au>Tomita, Yuri</au><au>Hashimoto, Hikaru</au><au>Kobayashi, Reo</au><au>Inoue, Ken</au><au>Hirose, Ryohei</au><au>Morimoto, Yasutaka</au><au>Inada, Yutaka</au><au>Murakami, Takaaki</au><au>Itoh, Yoshito</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Efficacy of hemostatic gel for perioperative bleeding and prevention of delayed bleeding of cold snare polypectomy under anticoagulant</atitle><jtitle>JGH open</jtitle><addtitle>JGH Open</addtitle><date>2024-01</date><risdate>2024</risdate><volume>8</volume><issue>1</issue><spage>e13029</spage><epage>n/a</epage><pages>e13029-n/a</pages><issn>2397-9070</issn><eissn>2397-9070</eissn><abstract>Background and Aim
A hemostatic gel, PuraStat (3‐D Matrix, Tokyo, Japan), is used for various gastrointestinal hemostasis. In this study, we analyzed the efficacy of PuraStat for perioperative bleeding (POB) and prevention of delayed bleeding (DB) to colorectal cold snare polypectomy (CSP) with continuous anticoagulant.
Methods
This was a single‐center, retrospective study. Subjects were lesions of 2–9 mm under continuous anticoagulant from 2021 to 2023 and treated with PuraStat for POB. The definition of POB was bleeding which did not stop spontaneously by 1.0–1.5 min after resection and needed hemostasis. Successful hemostasis was defined as cessation of bleeding within 1.0–1.5 min after spraying PuraStat and the rate of it and risk factors of POB were analyzed. For comparison, cases receiving previous CSP without PuraStat were extracted from all cases with CSP (2018‐2021), and POB and DB rate (DBR) were analyzed after propensity score matching.
Results
One hundred twenty‐two lesions (91: direct oral anticoagulant (DOAC), 31: warfarin) with anticoagulant were analyzed and the rate of successful hemostasis with PuraStat was 92.6% (DOAC/warfarin: 93.4%/80.6%, P = 0.01). The rate of DB was 0.0%. Multivariate analysis showed that significant risk factors about unsuccessful hemostasis for POB with PuraStat were lesion size 8–9 mm (P < 0.01), warfarin (P = 0.01), and combination of antiplatelet (P = 0.01). Regarding the comparison about CSP with/without PuraStat, the clipping rate and DBR were 8.5%/94.9% (P < 0.01) and 0%/1.7% (P = 1.0).
Conclusion
The effects of PuraStat for POB and DB in colorectal CSP with continuous anticoagulant were acceptable.
In this study, we analyzed 122 cases with colorectal cold snare polypectomy (CSP) with continuous anticoagulant (91 cases: direct oral anticoagulant, 31 cases: warfarin) treated with a hemostatic gel, PuraStat. The rates of successful hemostasis and delayed bleeding were 92.6% and 0.0%, respectively. The rate of clipping after CSP was reduced to 7.4%.</abstract><cop>Melbourne</cop><pub>Wiley Publishing Asia Pty Ltd</pub><pmid>38268964</pmid><doi>10.1002/jgh3.13029</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-6167-9705</orcidid><orcidid>https://orcid.org/0000-0002-7429-705X</orcidid><orcidid>https://orcid.org/0000-0002-3434-8107</orcidid><orcidid>https://orcid.org/0000-0002-0910-6915</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Wiley Online Library Open Access; Publicly Available Content Database; PubMed Central |
| subjects | Anticoagulants Cardiac arrhythmia Cardiovascular disease Catheters Cold cold snare polypectomy Colonoscopy colorectal polyps delayed bleeding Endoscopy Esophagus Hydrogels Morphology Original perioperative bleeding Polyps Prevention Risk factors Thromboembolism Tumors Ulcers |
| title | Efficacy of hemostatic gel for perioperative bleeding and prevention of delayed bleeding of cold snare polypectomy under anticoagulant |
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