Effectiveness of self-assembling peptide in reducing bleeding after colorectal endoscopic submucosal dissection.

Background and aims: The newly developed self-assembling peptide (SAP) is expected to exert hemostatic effects on the gastrointestinal tract and promote ulcer healing. However, its efficacy in preventing postprocedural hemorrhage after colorectal endoscopic submucosal dissection (ESD) remains uncertain. This study aimed to determine whether SAP could reduce hematochezia, including delayed bleeding (DB), and prevent its occurrence after colorectal ESD.

Methods: This multicenter retrospective study included 1597 patients with 1654 colorectal ESD-related lesions treated between January 2017 and July 2024. Initially, 1419 lesions were analyzed and categorized into non-SAP and SAP groups. Subsequently, the differences between lesions with and without postprocedural hematochezia and DB were explored. Factors associated with hematochezia and DB were examined using univariate and multivariate logistic regression analyses.

Results: A total of 719 and 700 lesions were assigned to the non-SAP and SAP groups, respectively. The use of SAP was associated with a significant reduction in hematochezia. In addition, SAP significantly reduced DB. SAP was identified as a significant factor in the prevention of hematochezia and DB after colorectal ESD.

Conclusions: The application of SAP significantly reduced the occurrence of hematochezia and DB after colorectal ESD. Furthermore, SAP was a significant factor associated with the reduction of hematochezia and DB. Therefore, SAP may be appropriate for the prevention of post-ESD bleeding in the colon.