Argon plasma coagulation for the endoscopic treatment of gastrointestinal tumor bleeding: A retrospective comparison with a non‐treated historical cohort

Martins, Bruno Costa; Wodak, Stephanie; Gusmon, Carla; Safatle‐Ribeiro, Adriana Vaz; Kawaguti, Fábio S.; Baba, Elisa Ryoka; Pennacchi, Caterina; Lima, Marcelo Simas de; Ribeiro, Ulysses; Maluf‐Filho, Fauze

doi:10.1177/2050640615590303

Cited by 25 publications

(18 citation statements)

References 21 publications

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“…6,12 Argon plasma coagulation is a noncontact thermal method of hemostasis that has been used to control bleeding from certain lesions in the GI tract and to debulk tumors for which surgery is not recommended. [17][18][19] Crespo Pérez et al published a report of using this technology to treat esophageal webs in a patient with PVS. 20 Of note, our patient had concomitant factor VII deficiency that hampered the use of argon plasma coagulation dilation.…”

Section: Discussionmentioning

confidence: 99%

Plummer-Vinson Syndrome With Concomitant Factor VII Deficiency

Kajy

Monday

Tannous

2019

TOJ

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Background: Plummer-Vinson syndrome (PVS), a rare disorder characterized by dysphagia, iron deficiency anemia, and esophageal webs, has principally been described in middle-aged women. This disorder is uncommon in the 21 st century because of the abundance of iron-fortified foods. Clotting factor deficiencies are also rare. Factor VII deficiency is a bleeding disorder characterized by the absence of a critical protein in the coagulation cascade. Case Report: We present a case of PVS associated with factor VII deficiency in a 26-year-old African American female. The patient had a history of anemia that was repeatedly attributed to menstrual bleeding and dysphagia for 10 years. She presented with symptomatic anemia requiring transfusion. She reported a history of food getting stuck in her chest, and workup revealed esophageal webs with no evidence of overt luminal gastrointestinal bleeding. Coagulation laboratory tests revealed the incidental finding of a borderline increased prothrombin time. Hematologic studies confirmed the presence of factor VII deficiency. Conclusion: To our knowledge, no case has been published about a patient diagnosed with PVS and concomitant factor VII deficiency. Our case illustrates several learning points: (1) PVS is an uncommon disorder that may still be diagnosed in a developed country in the 21 st century; (2) PVS requires close follow-up and esophageal surveillance because of the increased risk of esophageal cancer; (3) factor VII exhibits a high degree of phenotypic variability; (4) phenotype in factor VII deficiency does not always correlate with factor VII activity, although life-threatening spontaneous bleeding is not expected with levels >2%.

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Section: Discussionmentioning

confidence: 99%

Plummer-Vinson Syndrome With Concomitant Factor VII Deficiency

Kajy

Monday

Tannous

2019

TOJ

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“…Table 4 summarizes the results of those previous studies. The rate of immediate hemostasis with conventional ET in patients with acute UGIB from a malignant tumor was between 31 % and 100 % 6 12 13 14 15 16 17 18 . However, extensive effort and time are needed to achieve immediate hemostasis in patients with large bleeding tumors or oozing multifocal bleeding.…”

Section: Discussionmentioning

confidence: 99%

Hemostatic powder application for control of acute upper gastrointestinal bleeding in patients with gastric malignancy

et al. 2018

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Background and study aims Despite use of various endoscopic therapies in patients with tumor-related bleeding, various rates of successful immediate hemostasis and short-term rebleeding have been reported. We aimed to evaluate preliminary results of use of the EndoClot polysaccharide hemostatic system (PHS) in patients with acute upper gastrointestinal bleeding (UGIB) from a gastric malignancy. Patients and methods We retrospectively analyzed data from a prospectively collected database of 12 patients with acute UGIB from a gastric malignancy who had been treated with EndoClot PHS. The EndoClot air compressor was used to propel 2 g of absorbable modified polymer particles onto the bleeding site. We checked successful immediate hemostasis, rebleeding events and mortality within 30 days. Results Twelve patients were enrolled in the study. The median patient age was 72.5 years (range, 57 – 89). The initial median hemoglobin level was 6.75 g/dL (range, 5.4 – 8.9). The median systolic blood pressure was 114 mmHg (range, 86 – 153). Eleven patients had advanced gastric cancer and one patient had a gastrointestinal stromal tumor. The lower body of the stomach was the most common tumor location (58.3 %), and the median tumor size was 40 mm (range, 15 – 100). Immediate hemostasis was achieved in all patients, and rebleeding developed in 2 of 12 patients (16 %), 3 and 5 days after treatment. There were no significant Endoclot PHS-related adverse events, and there was no all-cause mortality at 30 days after the intervention. Conclusions Endoclot PHS represents a new alternative, complementary, and promising therapy for patients with an acute UGIB from a gastric malignancy.

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“…Likewise, Martins et al compared 25 patients with upper GI tumor bleeding who underwent APC with 28 patients who did not [21]. The study reported no differences in 30-day rebleeding (33.3% in the APC group vs. 14.3% in the control group; P=0.104) [22] (Table 1).…”

Section: Thermal Therapymentioning

confidence: 99%

Endoscopic management of bleeding gastrointestinal tumors

Ofosu

Ramai

Latson

et al. 2019

aog

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Bleeding due to primary or metastatic gastrointestinal (GI) tumors remains clinically challenging. Bleeding is further complicated in the setting of underlying friable neovascularization of tumors and coagulopathy. Endoscopic hemostatic therapeutic options have traditionally involved the use of thermal/mechanical therapy in conjunction with injection therapy. This review looks at the role of endoscopy in managing tumor-related GI bleeding, specifically contact and non-contact thermal therapy, radiofrequency ablation, endoloops, epinephrine and ethanol injection, and, most recently, Hemospray. Overall, current data show that endoscopic therapy is limited, with high rebleeding rates and a failure to improve overall outcomes. Larger clinical trials are needed to determine the efficacy of current techniques and establish therapeutic algorithms, with the goal of achieving primary hemostasis and reducing rebleeding rates.

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Argon plasma coagulation for the endoscopic treatment of gastrointestinal tumor bleeding: A retrospective comparison with a non‐treated historical cohort

Abstract: Endoscopic hemostasis of UGITB with APC has no significant impact on 30-day re-bleeding and mortality rates, irrespective of patient performance status.

Cited by 25 publications

References 21 publications

Plummer-Vinson Syndrome With Concomitant Factor VII Deficiency

Plummer-Vinson Syndrome With Concomitant Factor VII Deficiency

Hemostatic powder application for control of acute upper gastrointestinal bleeding in patients with gastric malignancy

Endoscopic management of bleeding gastrointestinal tumors

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