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Efficacy of Combination Therapy with Epinephrine Local Injection and Hemostatic Clips on Active Diverticular Bleeding
Epinephrine local injection is a hemostatic procedure used in active diverticular bleeding that elicits vasoconstriction and tamponade effects. We compared the additional benefit of combination therapy with HSE-C (hypertonic saline epinephrine injection with clipping) to clipping monotherapy. Retros...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9457277/ https://www.ncbi.nlm.nih.gov/pubmed/36079125 http://dx.doi.org/10.3390/jcm11175195 |
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author | Hamada, Seiji Teramoto, Akira Zukeyama, Ryuta Matsukawa, Shinobu Fukuhara, Tomofumi Takaki, Ryo Utsumi, Takahiro Nakamura, Masamoto Kobashikawa, Kasen Uchima, Nobufumi Nakayoshi, Tomokuni Kinjo, Fukunori |
author_facet | Hamada, Seiji Teramoto, Akira Zukeyama, Ryuta Matsukawa, Shinobu Fukuhara, Tomofumi Takaki, Ryo Utsumi, Takahiro Nakamura, Masamoto Kobashikawa, Kasen Uchima, Nobufumi Nakayoshi, Tomokuni Kinjo, Fukunori |
author_sort | Hamada, Seiji |
collection | PubMed |
description | Epinephrine local injection is a hemostatic procedure used in active diverticular bleeding that elicits vasoconstriction and tamponade effects. We compared the additional benefit of combination therapy with HSE-C (hypertonic saline epinephrine injection with clipping) to clipping monotherapy. Retrospective data on diverticular bleeding between 2011 and 2016 was reviewed. Those with an active bleeding source confirmed by colonoscopy (excluding non-bleeding vessels and adherent clots) who received either HSE-C or clipping were evaluated. Endpoints were rates of successful primary hemostasis, recurrent bleeding, and surgical intervention during hospitalization. A total of 320 patients with diverticular bleeding were evaluated, on which either HSE-C (n = 35) or clipping monotherapy (n = 18) was performed. Rates of successful primary hemostasis (91.4% vs. 66.7%, p = 0.048) and direct placement of endoclips (60.0% vs. 16.7%, p = 0.004) were significantly higher in the HSE-C group. Although not statistically significant, the HSE-C group had a higher rate of early rebleeding (18.8% vs. 8.3%, p = 0.653), while no difference was seen in the number of patients requiring surgery (11.4% vs. 5.5%, p = 0.651). HSE-C is associated with a higher rate of successful primary hemostasis for severe active diverticular bleeding but has no significant difference in reducing early recurrent bleeding or the number of patients requiring surgery, suggesting that hemostatic effects may be temporary. |
format | Online Article Text |
id | pubmed-9457277 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-94572772022-09-09 Efficacy of Combination Therapy with Epinephrine Local Injection and Hemostatic Clips on Active Diverticular Bleeding Hamada, Seiji Teramoto, Akira Zukeyama, Ryuta Matsukawa, Shinobu Fukuhara, Tomofumi Takaki, Ryo Utsumi, Takahiro Nakamura, Masamoto Kobashikawa, Kasen Uchima, Nobufumi Nakayoshi, Tomokuni Kinjo, Fukunori J Clin Med Article Epinephrine local injection is a hemostatic procedure used in active diverticular bleeding that elicits vasoconstriction and tamponade effects. We compared the additional benefit of combination therapy with HSE-C (hypertonic saline epinephrine injection with clipping) to clipping monotherapy. Retrospective data on diverticular bleeding between 2011 and 2016 was reviewed. Those with an active bleeding source confirmed by colonoscopy (excluding non-bleeding vessels and adherent clots) who received either HSE-C or clipping were evaluated. Endpoints were rates of successful primary hemostasis, recurrent bleeding, and surgical intervention during hospitalization. A total of 320 patients with diverticular bleeding were evaluated, on which either HSE-C (n = 35) or clipping monotherapy (n = 18) was performed. Rates of successful primary hemostasis (91.4% vs. 66.7%, p = 0.048) and direct placement of endoclips (60.0% vs. 16.7%, p = 0.004) were significantly higher in the HSE-C group. Although not statistically significant, the HSE-C group had a higher rate of early rebleeding (18.8% vs. 8.3%, p = 0.653), while no difference was seen in the number of patients requiring surgery (11.4% vs. 5.5%, p = 0.651). HSE-C is associated with a higher rate of successful primary hemostasis for severe active diverticular bleeding but has no significant difference in reducing early recurrent bleeding or the number of patients requiring surgery, suggesting that hemostatic effects may be temporary. MDPI 2022-09-02 /pmc/articles/PMC9457277/ /pubmed/36079125 http://dx.doi.org/10.3390/jcm11175195 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Hamada, Seiji Teramoto, Akira Zukeyama, Ryuta Matsukawa, Shinobu Fukuhara, Tomofumi Takaki, Ryo Utsumi, Takahiro Nakamura, Masamoto Kobashikawa, Kasen Uchima, Nobufumi Nakayoshi, Tomokuni Kinjo, Fukunori Efficacy of Combination Therapy with Epinephrine Local Injection and Hemostatic Clips on Active Diverticular Bleeding |
title | Efficacy of Combination Therapy with Epinephrine Local Injection and Hemostatic Clips on Active Diverticular Bleeding |
title_full | Efficacy of Combination Therapy with Epinephrine Local Injection and Hemostatic Clips on Active Diverticular Bleeding |
title_fullStr | Efficacy of Combination Therapy with Epinephrine Local Injection and Hemostatic Clips on Active Diverticular Bleeding |
title_full_unstemmed | Efficacy of Combination Therapy with Epinephrine Local Injection and Hemostatic Clips on Active Diverticular Bleeding |
title_short | Efficacy of Combination Therapy with Epinephrine Local Injection and Hemostatic Clips on Active Diverticular Bleeding |
title_sort | efficacy of combination therapy with epinephrine local injection and hemostatic clips on active diverticular bleeding |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9457277/ https://www.ncbi.nlm.nih.gov/pubmed/36079125 http://dx.doi.org/10.3390/jcm11175195 |
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