Randomized comparison of Nd YAG laser, heater probe, and no endoscopic therapy for bleeding peptic ulcers.
Of 550 patients admitted with acute upper gastrointestinal hemorrhage, 143 with peptic ulcers containing stigmata of recent hemorrhage accessible to endoscopic therapy were included in a randomized comparison of neodymium yttrium aluminum garnet laser, heater probe, and no endoscopic therapy. The rebleeding rate in laser-treated patients (20%) was significantly less than in controls (42%; p less than 0.05), but in heater probe-treated patients (28%) it was not significantly different from either of the other two groups. The mortality rate in the laser group (2%) was not significantly different from either the heater probe (10%) or the control (9%) group. This trial has confirmed the efficacy of the Nd YAG laser but not that of the heater probe in the prevention of rebleeding from recently bleeding peptic ulcers.
Matthewson
K
K
Norman Tanner Gastroenterology Unit, St. James' Hospital, London, England.
Swain
C P
CP
Bland
M
M
Kirkham
J S
JS
Bown
S G
SG
Northfield
T C
TC
D004381:Duodenal Ulcer / Q000150:complications* / Q000401:mortality / Q000601:surgery; D004384:Duodenoscopy; D004564:Electrocoagulation / Q000295:instrumentation / Q000379:methods; D004630:Emergencies; D005069:Evaluation Studies as Topic; D005773:Gastroscopy; D006801:Humans; D008028:Light Coagulation / Q000295:instrumentation / Q000379:methods; D010438:Peptic Ulcer Hemorrhage / Q000401:mortality / Q000601:surgery*; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D013276:Stomach Ulcer / Q000150:complications* / Q000401:mortality / Q000601:surgery