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• W3034095302 abstract "Gastrointestinal bleeding represents a potentially life threatening condition and it’s an indication for the realization of endoscopy. The incidence of upper gastrointestinal bleeding (UGB) is approximately 150 patients for every 100.000 person/year, with a mortality rate up to 10%. There’s multiple sources of bleeding that can be identified and the treatment is according to the type of lesion. 10–30% of patients in which hemostasis cannot be achieved or there is recurrence of bleeding by conventional treatment. Hemostatic mineral powder (HMP) has an elevated success rate, nonetheless its recurrence rate is up to 38.9%. Objective: To evaluate the performance of mineral hemostatic powder for the different types of UGB. Data on patients with active UGB treated with HMP (Hemospray) admitted for EGD to the Endoscopy Unit (Hospital General de México, Ciudad de México) between September 2018 and November 2019 were analyzed retrospectively. The collected data were summarized with descriptive statistics. We included 46 patients with UGB in which HMP was used for different indications, peptic ulcer (39.1%) being the most frequent, followed by tumor bleeding (23.9%), gastric variceal bleeding (17.4%), esophageal post-banding ulcer (10.9%), esophageal variceal bleeding (4.3%), and post-sphincterotomy bleeding (4.3%). 56.5% were men (n=26), mean age 53.8 ± 16.1 years. The bleeding type was spurting in 17% and oozing in 82.6%. Mean hemoglobin at admission was 8.24 ± 2.25 g/dL, at 24 hours 7.99 ± 1.72 g/dL, and at 48 hours 8.54 ± 1.80 g/dL. The treatment was HMP alone in 78.3%, HMP and epinephrine in 19.6% and HMP, epinephrine and argon-plasma coagulation in 2.2%. Acute hemostasis was achieved in all patients. Rebleeding rate was 21.7% in all groups, 11.1% for the peptic ulcer group (2/18), 27.3% for the tumor bleeding group (3/11), 37.5% for the gastric variceal bleeding group (3/8), 20% in the post-banding ulcer group (1/5) and 50% in the post-sphincterotomy group (1/2). There were no rebleeding in the esophageal variceal bleeding group (0/2). The rebleeding rate between types of bleeding was 25% for the spurting group, and 18.4% for the oozing group. There was a 22.2% rebleeding rate for the combined epinephrine and HMP group, and no rebleeding for the triple therapy group. There was a need for transfusion in 10.9% of cases after treatment. No procedure-related adverse events were associated with the use of the hemostatic mineral powder. In our study we found that our overall recurrence rate was inferior than in other case series (21.7% vs 38.9%) and more markedly in the peptic ulcer group (11.1%). We believe HMP is an adequate therapy for all types of active UGB, nonetheless up to 20% of cases present rebleeding, being more evident in the ulcerated tumor and gastric variceal bleeding group." @default.
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• W3034095302 date "2020-06-01" @default.
• W3034095302 modified "2023-10-14" @default.
• W3034095302 title "Tu1511 IMPACT OF HEMOSTATIC MINERAL POWDER FOR ALL TYPES OF UPPER GASTROINTESTINAL BLEEDING IN A DEVELOPING COUNTRY" @default.
• W3034095302 doi "https://doi.org/10.1016/j.gie.2020.03.3683" @default.
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