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• W1981384660 abstract "Upper gastrointestinal bleeding (UGIB) is a frequent life-threatening condition. Endoscopic haemostasis and proton-pump inhibitors are the first-line treatments of hemorrhagic ulcers. Simulators, ex vivo animal models are currently used for training in endoscopic haemostasis, but they have important limitations. We aimed to validate a reproducible, realistic, quick-and-easy live animal model of acute bleeding ulcer for endoscopy training. After approval of local animal ethics committee, fourteen 25-30 kg pigs were used to validate the model. The following sequence was used: animals received clopidogrel 600 mg and aspirin 2 g per day during 5 days before the procedure; unfractioned heparin was given all along the procedure (bolus of 25,000 UI then 10,000 UI per hour); repeated grasp-and-snare mucosectomies were performed in each animal. Ulcers were evaluated in the first six animals to assess reproducibility (bleeding rate), bleeding type (Forrest classification), number of bleeding ulcers by animal, and time needed for bleeding ulcer creation. Then likelihood of ulcer bleeding model was assessed by ten endoscopic experts with a Likert scale in 4 points (3 ulcers each). The utility of training with the model was evaluated with 16 fellows during two dedicated training sessions by pre and post-test performed with a Likert scale in 4 points by two endoscopists (three haemostatic technics: epinephrin injection, bipolar electrocoagulation, hemoclipping). The satisfaction of the fellows was also noticed with a Likert scale. Fifty-three gastric ulcers were created in the first 6 animals (8.8 +/− 1.5 ulcers per animal). Successful simulation of active ulcer bleeding (Forrest Ib) was achieved in 96.2%. Bleeding was moderate to abundant in 77.2% of ulcers. Ulcerations consistently reached the submucosa layer. Mean time to achieve a bleeding ulcer was 3.8 minutes +/− 0.6. Endoscopic experts evaluated the likelihood of ulcer and bleeding at 3.2 +/− 0.7 and 3.6 +/− 0.7 respectively, with a Likert scale in 4-points. The training with the ulcer bleeding model improved significantly the endoscopic skills of the 16 fellows (pre-test: 1.9 ± 0.6, post-test: 3.5 ± 0.1; p<0.01). The mean overall satisfaction of the fellows was 4.0 ± 0.0, their overall satisfaction with the animal model was 3.9 ±0.3. The live porcine model was demonstrated reproducible (96% of Forrest Ib ulcers), realistic (3.6 on a 4-point scale, as evaluated by expert), and quick-and-easy to perform (pure endoscopic procedure, mean time 4 minutes per bleeding ulcer). It was favourably evaluated as an excellent training model for endoscopic treatment of bleeding ulcers. We are currently working on the validation of the model for research purposes (i.e. evaluation of haemostatic tools prior to assessment in human)." @default.
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• W1981384660 date "2011-04-01" @default.
• W1981384660 modified "2023-10-16" @default.
• W1981384660 title "Tu1403 A Live Porcine Model of Bleeding Ulcer" @default.
• W1981384660 doi "https://doi.org/10.1016/j.gie.2011.03.895" @default.
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