A prospective, randomized trial of large- versus small-volume endoscopic injection of epinephrine for peptic ulcer bleeding

Lin, Hwai Jeng; Hsieh, Yu Hsi; Tseng, Guan Ying; Perng, Cherng-Kang; Chang, Full Young; Lee, Shou Dong

doi:10.1067/mge.2002.123271

Cited by 127 publications

(46 citation statements)

References 25 publications

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“…The use of local adrenalin during SPS operations to provide a dry wound is not a new method, there are already some authors using this method routinely [9,10]. But in a literature investigation, we did not find any prospective, randomized study showing the effectiveness of adrenalin on bleeding during SPS operations.…”

Section: Discussionmentioning

confidence: 80%

Efficacy of Local Adrenalin Injection during Sacrococcygeal Pilonidal Sinus Excision

Ayşan¹,

Başak²,

Kinaci³

et al. 2004

Eur Surg Res

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Background: The most commonly preferred treatment method for sacrococcygeal pilonidal sinus disease is surgery. Peroperative and postoperative hemorrhages may develop frequently because of the increased vascularity of the region. The aim of this study was to evaluate the effects of adrenalin, a potent vasoconstrictor agent, on pilonidal sinus operations in comparison to a control group. Methods: A prospective, randomized, double-blind, clinical study was designed and 51 patients with symptomatic, uncomplicated pilonidal disease were included (44 males and 7 females; mean age 24.5, range 16–44 years). Adrenalin 0.1 mg with 10 ml 0.9% NaCl (1/100,000 dilution) was injected through the incision tracts to all layers and the base of the incision area in group 1 (n = 21). The same process was applied to group 2 (n = 21) with 10 ml physiological serum solution. Then, after removal of the sinus and its tracks, a suction-type drain was placed in the pouch in all cases and the incision was primarily closed. Peroperative and postoperative hemorrhage, and operation time were accepted as the evaluation criteria. Cases were followed for 6 months postoperatively. Results: The amount of peroperative hemorrhage was 6.5 ± 3.5 ml in group 1 and 17.5 ± 9.5 ml in group 2 (p < 0.001). The postoperative hemorrhage was 11 ± 7.5 ml in group 1 and 13.5 ± 6 ml in group 2 (p > 0.05). The operation time was 14 ± 5 min in group 1 and 22 ± 8.5 min in group 2 (p < 0.05). No reactionary hemorrhage, hematoma or recurrence was seen during the follow-up period. Conclusions: Adrenalin injection is quite effective to decrease peroperative bleeding and operation time, but it does not decrease postoperative bleeding and the need for a drain.

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Section: Discussionmentioning

confidence: 80%

Efficacy of Local Adrenalin Injection during Sacrococcygeal Pilonidal Sinus Excision

Ayşan¹,

Başak²,

Kinaci³

et al. 2004

Eur Surg Res

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“…O avanço na terapêutica endoscópica possibilitou abordagem da angiodisplasia intestinal. Vários mé-todos têm sido utilizados para hemostasia, tais como: injeção de soluções na submucosa (soro fisiológico, esclerosantes, vasoconstrictores); e métodos térmicos (cautérios monopolar e bipolar, gás Argônio) 4,5,6,7,8,9 . A predominância das lesões no cólon direito significa risco maior de complicações no tratamento das anomalias vasculares.…”

Section: Discussionunclassified

Novo método para tratamento da angiodisplasia de cólon

Freitas

Santos

Todeschi

et al. 2009

Rev bras. colo-proctol.

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RESUMO: A utilização da colonoscopia como método de diagnóstico e tratamento possibilitou avanços na abordagem da angiodisplasia de cólon, anomalia vascular responsável por um terço das hemorragias gastrointestinais baixas. Trata-se de paciente com 65 anos, insuficiência renal crônica dialítica e coronariopata grave, apresentando episódios de hematoquezia volumosa ao iniciar uso de agregantes plaquetários, necessitando múltiplas hemotransfusões. Colonoscopia diagnosticou lesões vasculares no ceco, onde existe grande risco de perfuração durante intervenções terapêuticas. Há descrições na literatura do uso de agentes hemostáticos tais como plasma de Argônio e vasoconstrictores, aplicados separadamente. Foi realizado tratamento endoscópico das angiodisplasias com aplicação de Argônio, após elevação das lesões com soro fisiológico, e pela primeira vez descrita no Brasil, acrescentado vasoconstrictor à solução.

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“…All injection therapies primarily achieve hemostasis through local tissue and vascular tamponade [5,53] . Additionally, thrombin and fibrin injection can create a tissue seal at the site of bleeding, whereas sclerosants provoke direct tissue injury and induce thrombosis.…”

Section: Endoscopic Treatment Modalitiesmentioning

confidence: 99%

“…Additionally, thrombin and fibrin injection can create a tissue seal at the site of bleeding, whereas sclerosants provoke direct tissue injury and induce thrombosis. This is associated with more tissue necrosis, limiting sclerosant use to < 1mL [5,53] . …”

Section: Endoscopic Treatment Modalitiesmentioning

confidence: 99%

Endoscopic Management of Acute Non Variceal Upper Gastrointestinal Bleeding

Barkun

2015

Journal of Gastroenterology and Hepatology Research

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A prospective, randomized trial of large- versus small-volume endoscopic injection of epinephrine for peptic ulcer bleeding

Cited by 127 publications

References 25 publications

Efficacy of Local Adrenalin Injection during Sacrococcygeal Pilonidal Sinus Excision

Efficacy of Local Adrenalin Injection during Sacrococcygeal Pilonidal Sinus Excision

Novo método para tratamento da angiodisplasia de cólon

Endoscopic Management of Acute Non Variceal Upper Gastrointestinal Bleeding

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