Endoscopic application of novel, infection-free, advanced hemostatic material: Its usefulness to upper gastrointestinal oozing.
endoscopic submucosal dissection
endoscopic surgery
flexible endoscopy
hemostatic material
self‐assembling peptides
Journal
DEN open
ISSN: 2692-4609
Titre abrégé: DEN Open
Pays: Australia
ID NLM: 9918317682706676
Informations de publication
Date de publication:
Apr 2022
Apr 2022
Historique:
received:
16
02
2021
revised:
28
04
2021
accepted:
29
04
2021
entrez:
21
3
2022
pubmed:
22
3
2022
medline:
22
3
2022
Statut:
epublish
Résumé
Self-assembling peptides (TDMs) comprise synthetic amphipathic peptides that immediately react to changes in pH and/or inorganic salts to transform into a gelatinous state. The first generation of these peptides (TDM-621) is currently used as a hemostatic agent in Europe. However, TDM-621 exhibits slow gel-formation and low retention capabilities on tissue surfaces. The second generation (TDM-623) was therefore developed to encourage faster gel-formation and better tissue-sealing capabilities. The aim of this study was to verify the efficacy of TDM-623 in terms of its hemostatic effect in endoscopic surgery. Evaluation of the hemostatic effect in endoscopic surgery (animal study) was performed using eight porcine in spine position. Following systemic heparinization, we established a "bleeding model" by endoscopic grasping forceps on the anterior walls of the stomach and duodenum. In the hemostasis method, an endoscope with a distal hood was brought into contact with the bleeding point, and 1 ml TDM-623 was applied to the wound. After TDM-623 gelation, the endoscope was removed, and the acute hemostatic effect (after 2 min) was confirmed. In the endoscopic bleeding model, 17 of the 23 cases (74%) showed complete hemostatic effects on the anterior wall of the stomach, and 18 of the 20 cases (80%) on the anterior wall of the duodenum, respectively. None of the applied gels were displaced from the anterior walls of the stomach and duodenum. The new self-assembling peptide (TDM-623) showed high hemostatic effects. TDM-623 had potential usefulness for upper gastrointestinal endoscopic surgery.
Sections du résumé
Background
UNASSIGNED
Self-assembling peptides (TDMs) comprise synthetic amphipathic peptides that immediately react to changes in pH and/or inorganic salts to transform into a gelatinous state. The first generation of these peptides (TDM-621) is currently used as a hemostatic agent in Europe. However, TDM-621 exhibits slow gel-formation and low retention capabilities on tissue surfaces. The second generation (TDM-623) was therefore developed to encourage faster gel-formation and better tissue-sealing capabilities.
Aim
UNASSIGNED
The aim of this study was to verify the efficacy of TDM-623 in terms of its hemostatic effect in endoscopic surgery.
Materials and methods
UNASSIGNED
Evaluation of the hemostatic effect in endoscopic surgery (animal study) was performed using eight porcine in spine position. Following systemic heparinization, we established a "bleeding model" by endoscopic grasping forceps on the anterior walls of the stomach and duodenum. In the hemostasis method, an endoscope with a distal hood was brought into contact with the bleeding point, and 1 ml TDM-623 was applied to the wound. After TDM-623 gelation, the endoscope was removed, and the acute hemostatic effect (after 2 min) was confirmed.
Result
UNASSIGNED
In the endoscopic bleeding model, 17 of the 23 cases (74%) showed complete hemostatic effects on the anterior wall of the stomach, and 18 of the 20 cases (80%) on the anterior wall of the duodenum, respectively. None of the applied gels were displaced from the anterior walls of the stomach and duodenum.
Conclusion
UNASSIGNED
The new self-assembling peptide (TDM-623) showed high hemostatic effects. TDM-623 had potential usefulness for upper gastrointestinal endoscopic surgery.
Identifiants
pubmed: 35310741
doi: 10.1002/deo2.25
pii: DEO225
pmc: PMC8828191
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e25Informations de copyright
© 2021 The Authors. DEN Open published by John Wiley & Sons Australia, Ltd on behalf of Japan Gastroenterological Endoscopy Society.
Déclaration de conflit d'intérêts
The authors declare that they have no conflict of interest.
Références
Endosc Int Open. 2016 Apr;4(4):E415-9
pubmed: 27092320
J Pept Sci. 2008 Feb;14(2):152-62
pubmed: 18196533
Am J Gastroenterol. 2015 Feb;110(2):221
pubmed: 25646906
Eur J Trauma Emerg Surg. 2015 Oct;41(5):493-500
pubmed: 26037982
Ann Thorac Cardiovasc Surg. 2012;18(5):444-51
pubmed: 22986759
Vox Sang. 2005 Feb;88(2):77-86
pubmed: 15720604
Dig Endosc. 2015 Nov;27(7):720-5
pubmed: 26258405
Lancet. 2007 Dec 15;370(9604):2063-7
pubmed: 18083405
J Natl Med Assoc. 1991 May;83(5):416-8
pubmed: 1875421
Int J Surg Case Rep. 2017 Nov 20;41:461-464
pubmed: 29546017
Gastrointest Endosc. 2016 Jun;83(6):1259-64
pubmed: 26608126
Gastrointest Endosc. 2009 May;69(6):987-96
pubmed: 19410037
Lancet. 1981 Mar 21;1(8221):664-5
pubmed: 6110886
J Blood Transfus. 2016;2016:4860284
pubmed: 28070448
J Thromb Thrombolysis. 2009 Jul;28(1):1-5
pubmed: 18629446
J Biomed Mater Res. 2002;63(1):37-47
pubmed: 11787027
J Gastroenterol Hepatol. 2014 Dec;29 Suppl 4:77-9
pubmed: 25521738
Br J Surg. 2008 Oct;95(10):1197-225
pubmed: 18763249
Minim Invasive Ther Allied Technol. 2020 Oct;29(5):283-292
pubmed: 31187670