Retrospective multicenter study concerning electrocautery forceps with soft coagulation for nonmalignant gastroduodenal ulcer bleeding in Japan.
Electrocautery forceps with soft coagulation are actively used for treatment of bleeding and nonbleeding visible vessels during endoscopic submucosal dissection, but the usefulness of gastroduodenal ulcer bleeding has not been elucidated so far. The purpose of this paper is to elucidate the outcomes of electrocautery forceps with soft coagulation for peptic and artificial gastroduodenal ulcer bleeding. A retrospective multicenter study of consecutive case series during one year involved nine departments of high-volume hospitals in Japan. The study included 128 consecutive patients (62 with peptic ulcers and 66 with artificial ulcers) with bleeding nonmalignant gastroduodenal ulcers that were revealed using emergency endoscopy between January 2008 and December 2008. Hemostasis was carried out using electrocautery forceps with soft coagulation. Rates of successful initial hemostasis, rebleeding, transfer to surgery, and death according to peptic and artificial ulcer bleeding were recorded. Successful initial endoscopic hemostasis was obtained in 61 peptic ulcer patients (98.4%) and 66 artificial ulcer patients (100%). Rebleeding was observed in seven peptic ulcer patients (11.5%) and five artificial ulcer patients (7.6%). Rates of successful management with endoscopic methods alone were 96.8% (60/62) and 100% (66/66) in peptic ulcer patients and artificial ulcer patients, respectively. There were no severe complications or deaths related to the management of gastroduodenal ulcer bleeding. The novel endoscopic method using electrocautery forceps with soft coagulation for gastroduodenal ulcer bleeding seems to provide safety and efficacy that is comparable with that of endoscopic hemostasis with other established hemostatic techniques.
Fujishiro
Mitsuhiro
M
Department of Endoscopy and Endoscopic Surgery, The University of Tokyo, Tokyo, Japan. mtfujish-kkr@umin.ac.jp
Abe
Nobutsugu
N
Endo
Masaki
M
Kawahara
Yoshiro
Y
Shimoda
Ryo
R
Nagata
Shinji
S
Homma
Kiyoaki
K
Morita
Yoshinori
Y
Uedo
Noriya
N
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004381:Duodenal Ulcer; D004564:Electrocoagulation / Q000295:instrumentation*; D020776:Endoscopes, Gastrointestinal; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D016558:Hemostasis, Endoscopic / Q000295:instrumentation*; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000453:epidemiology / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D013276:Stomach Ulcer; D055815:Young Adult