{"title":"Eficacia del uso de polvo hemostático para el manejo endoscópico de la hemorragia digestiva alta de origen tumoral","authors":"J.P. Pérez-Macías, M.E. Ramírez- Solís, A.I. Hernández-Guerrero, J.G. Dela Mora- Levy, W.D. Torrecilla- Ramírez, B.A. Sánchez-Jiménez, G.M. Salgado-Castellón","doi":"10.1016/j.rgmx.2024.10.004","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>Upper gastrointestinal bleeding (UGIB) of neoplastic origin is a rare but life-threatening cause of bleeding. Endoscopic treatment is challenging due to diffuse oozing blood and high rates of rebleeding, despite coagulation and hemoclip use. Hemostatic powders can be an option in those patients. We aimed to determine the initial hemostatic rate and the rebleeding rate at 7 and 30 days, using hemostatic powders in patients with malignant UGIB at a national referral center in Mexico.</div></div><div><h3>Material and methods</h3><div>A retrospective, observational study was conducted on patients with malignant UGIB treated with hemostatic powder between 2018-2023. Demographic and clinical variables, endoscopic findings, and treatment results were analyzed. A central tendency analysis and the chi-square test were employed.</div></div><div><h3>Results</h3><div>The study included 54 patients (54.7% were men), with a mean age of 54 years. A total of 40.7% were diagnosed with gastric cancer and presented with an episode of malignant UGIB. Of the endoscopic findings, 52% of patients had active malignant UGIB, most presenting with oozing bleeding (57.4%). EndoClot™ was the main monotherapy employed (81.5%), achieving initial homeostasis in 100% of cases. The rebleeding rate was 22.2% at 7 days and 44.4% at 30 days, with a 30-day accumulated mortality rate of 35.2%.</div></div><div><h3>Conclusions</h3><div>Malignant UGIB is a potentially life-threatening complication. Hemostatic powder use is highly recommendable due to its efficacy in the immediate control of bleeding. Nevertheless, its effect is temporary, suggesting its use as bridging therapy, facilitating bleeding stabilization and enabling the implementation of definitive hemostatic treatments.</div></div>","PeriodicalId":51767,"journal":{"name":"Revista de Gastroenterologia de Mexico","volume":"90 2","pages":"Pages 199-206"},"PeriodicalIF":1.7000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Revista de Gastroenterologia de Mexico","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S037509062500031X","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction
Upper gastrointestinal bleeding (UGIB) of neoplastic origin is a rare but life-threatening cause of bleeding. Endoscopic treatment is challenging due to diffuse oozing blood and high rates of rebleeding, despite coagulation and hemoclip use. Hemostatic powders can be an option in those patients. We aimed to determine the initial hemostatic rate and the rebleeding rate at 7 and 30 days, using hemostatic powders in patients with malignant UGIB at a national referral center in Mexico.
Material and methods
A retrospective, observational study was conducted on patients with malignant UGIB treated with hemostatic powder between 2018-2023. Demographic and clinical variables, endoscopic findings, and treatment results were analyzed. A central tendency analysis and the chi-square test were employed.
Results
The study included 54 patients (54.7% were men), with a mean age of 54 years. A total of 40.7% were diagnosed with gastric cancer and presented with an episode of malignant UGIB. Of the endoscopic findings, 52% of patients had active malignant UGIB, most presenting with oozing bleeding (57.4%). EndoClot™ was the main monotherapy employed (81.5%), achieving initial homeostasis in 100% of cases. The rebleeding rate was 22.2% at 7 days and 44.4% at 30 days, with a 30-day accumulated mortality rate of 35.2%.
Conclusions
Malignant UGIB is a potentially life-threatening complication. Hemostatic powder use is highly recommendable due to its efficacy in the immediate control of bleeding. Nevertheless, its effect is temporary, suggesting its use as bridging therapy, facilitating bleeding stabilization and enabling the implementation of definitive hemostatic treatments.
期刊介绍:
La Revista de Gastroenterología de México es el órgano oficial de la Asociación Mexicana de Gastroenterología. Sus espacios están abiertos a los miembros de la Asociación como a todo miembro de la comunidad médica que manifieste interés por utilizar este foro para publicar sus trabajos, cumpliendo con las políticas editoriales que a continuación se mencionan. El objetivo principal de la Revista de Gastroenterología de México, es publicar trabajos originales del amplio campo de la gastroenterología, así como proporcionar información actualizada y relevante para el área de la especialidad y áreas afines. Los trabajos científicos incluyen las áreas de Gastroenterología clínica, endoscópica, quirúrgica y pediátrica.