title: Hemostatic effect of oxidized regenerated cellulose in an experimental gastric mucosal resection model.
abstract: OBJECTIVE
  The endoscopic hemostatic therapies currently available do not always result in hemostasis of gastrointestinal bleeding. Oxidized regenerated cellulose (ORC) mesh is a widely available surgical hemostatic material. The aim of this study was to evaluate the hemostatic efficacy of ORC in experimental gastric hemorrhage after endoscopic resection.
  
  
  METHODS
  This was a prospective, two-stage experimental, Phase I, proof-of-concept study. In Stage 1, eight gastric mucosal lesions were created in anticoagulated rabbits and treated with ORC (closed or open pores). In Stage 2, the endoscopic introduction and application of ORC mesh pieces were evaluated in a porcine model of endoscopic submucosal dissection (ESD).
  
  
  RESULTS
  In Stage 1, hemostasis was achieved in all lesions. Hemostasis was achieved more rapidly with closed-pore than open-pore ORC (24.5 vs. 66.5 seconds) (P < 0.01). At 24 hours, all lesions showed persistent hemostasis. There were no episodes of rebleeding, complications, or mortality. In Stage 2, the endoscopic introduction of ORC pieces and application with a biopsy forceps were feasible in all ESD lesions.
  
  
  CONCLUSIONS
  ORC was an effective hemostatic agent for bleeding lesions following mucosal resection in anticoagulated rabbits. Closed-pore ORC achieved hemostasis faster than open-pore ORC. Endoscopic introduction and release of ORC were feasible.
authors.affiliation: Instituto Nacional de Cancerología, Distrito Federal, México.
authors.forename: Jacobo
authors.initials: J
authors.lastname: Velázquez-Aviña
authors.affiliation: Basil I. Hirschowitz Endoscopic Center of Excellence, Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, Alabama, USA.
authors.forename: Klaus
authors.initials: K
authors.lastname: Mönkemüller
authors.affiliation: Hospital Das Clinicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Paulo
authors.initials: P
authors.lastname: Sakai
authors.affiliation: Hospital Das Clinicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Marianny
authors.initials: M
authors.lastname: Sulbaran
authors.affiliation: Instituto Nacional de Cancerología, Distrito Federal, México.
authors.forename: Carlos
authors.initials: C
authors.lastname: Chávez-Vargas
authors.affiliation: Surgical Experimental Unit, Facultad de Medicina, Universidad Nacional Autónoma de México, México City, Mexico.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Montalvo Javé
authors.affiliation: Instituto Nacional de Cancerología, Distrito Federal, México.
authors.forename: Sergio
authors.initials: S
authors.lastname: Sobrino-Cossío
mesh_terms: D000818:Animals; D002483:Cellulose, Oxidized / Q000627:therapeutic use*; D004195:Disease Models, Animal; D004210:Dissection / Q000009:adverse effects; D005240:Feasibility Studies; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects; D005753:Gastric Mucosa / Q000601:surgery; D006471:Gastrointestinal Hemorrhage / Q000628:therapy*; D016558:Hemostasis, Endoscopic / Q000379:methods*; D006490:Hemostatics / Q000627:therapeutic use*; D008297:Male; D011446:Prospective Studies; D011817:Rabbits; D013272:Stomach Diseases / Q000628:therapy*; D013552:Swine
chemical_list: D002483:Cellulose, Oxidized; D006490:Hemostatics