Efficacy of hemostatic powders in lower gastrointestinal bleeding: Clinical series and literature review.
Diverticular disease
Hemospray
Hemostasis
Lower GI bleeding
Tumor
Journal
Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
ISSN: 1878-3562
Titre abrégé: Dig Liver Dis
Pays: Netherlands
ID NLM: 100958385
Informations de publication
Date de publication:
Oct 2021
Oct 2021
Historique:
received:
04
03
2021
revised:
12
04
2021
accepted:
17
05
2021
pubmed:
15
6
2021
medline:
5
2
2022
entrez:
14
6
2021
Statut:
ppublish
Résumé
There is limited evidence on the efficacy of hemostatic powders in the management of lower gastrointestinal bleeding. to revise our series of patients with lower gastrointestinal bleeding treated with hemostatic powders and to provide a pooled estimate of their efficacy based on the current literature. Sixty-five patients underwent topical endoscopic application of hemostatic powder between 2016 and 2020. The primary endpoint was treatment success, with 7- and 30-day rebleeding rate, adverse events and mortality as secondary outcomes. Literature review was based on computerized bibliographic search on the main databases through December 2020. Pooled effects were calculated using a random-effects model. Overall, the powder was applied as monotherapy in 37 patients (56.9%), as combination therapy in 15 patients (23.4%), and as rescue therapy in 13 cases (19.9%). Hemostasis was achieved in 100% of patients. Rebleeding rate at 7- and 30-day was 7.7% and 9.2%, respectively. A total of 10 studies with 259 patients were included in the meta-analysis. Immediate hemostasis was achieved in 96.3% (93.4%-99.2%) patients, whereas pooled 7- and 30-day rebleeding rates were 9.6% (4.5%-14.6%) and 12.9% (7.2%-18.5%), respectively. Novel hemostatic powders represent a user-friendly and effective tool in the management of lower gastrointestinal bleeding.
Sections du résumé
BACKGROUND
BACKGROUND
There is limited evidence on the efficacy of hemostatic powders in the management of lower gastrointestinal bleeding.
AIMS
OBJECTIVE
to revise our series of patients with lower gastrointestinal bleeding treated with hemostatic powders and to provide a pooled estimate of their efficacy based on the current literature.
METHODS
METHODS
Sixty-five patients underwent topical endoscopic application of hemostatic powder between 2016 and 2020. The primary endpoint was treatment success, with 7- and 30-day rebleeding rate, adverse events and mortality as secondary outcomes. Literature review was based on computerized bibliographic search on the main databases through December 2020. Pooled effects were calculated using a random-effects model.
RESULTS
RESULTS
Overall, the powder was applied as monotherapy in 37 patients (56.9%), as combination therapy in 15 patients (23.4%), and as rescue therapy in 13 cases (19.9%). Hemostasis was achieved in 100% of patients. Rebleeding rate at 7- and 30-day was 7.7% and 9.2%, respectively. A total of 10 studies with 259 patients were included in the meta-analysis. Immediate hemostasis was achieved in 96.3% (93.4%-99.2%) patients, whereas pooled 7- and 30-day rebleeding rates were 9.6% (4.5%-14.6%) and 12.9% (7.2%-18.5%), respectively.
CONCLUSION
CONCLUSIONS
Novel hemostatic powders represent a user-friendly and effective tool in the management of lower gastrointestinal bleeding.
Identifiants
pubmed: 34120857
pii: S1590-8658(21)00277-2
doi: 10.1016/j.dld.2021.05.026
pii:
doi:
Substances chimiques
Hemostatics
0
Powders
0
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1327-1333Informations de copyright
Copyright © 2021. Published by Elsevier Ltd.
Déclaration de conflit d'intérêts
Declaration of Competing Interest None.