Prospective comparison of argon plasma coagulator and heater probe in the endoscopic treatment of major peptic ulcer bleeding☆,☆☆,★
Section snippets
PATIENTS AND METHODS
All patients admitted for upper gastrointestinal bleeding (UGIB) and those who presented with UGIB after admission for unrelated disorders were considered. UGIB was diagnosed only if medical or nursing staff members witnessed either hematemesis or melena; observed bloody nasogastric aspirate; or detected black, tarry material on digital rectal examination. Patients were included in the study if emergency endoscopy showed a gastric or duodenal ulcer with either an actively bleeding vessel
RESULTS
From July 1996 through January 1997, 284 patients with UGIB were encountered; of these, 115 underwent emergency endoscopy. Ulcers were considered the source of bleeding in 50 patients. According to predefined endoscopic criteria, 41 consecutive patients with major stigmata of ulcer bleeding were randomly assigned to receive either HP (20 patients) or APC treatment (21 patients). Three patients were excluded because the bleeding lesion could not be seen, whereas another six had either a gray
DISCUSSION
UGIB caused by peptic ulcers is a serious and potentially life-threatening condition. The past two decades have witnessed the development of several effective methods of endoscopic hemostasis, including injection therapy, multipolar electrocoagulation, HP thermocoagulation, laser coagulation, and clipping. Contact probes, tissue injection with epinephrine or sclerosing agents, and laser treatment have all been extensively evaluated.1, 2, 3, 4 In prospective trials of endoscopic hemostasis,
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2018, Gastrointestinal Endoscopy Clinics of North AmericaCitation Excerpt :Despite the mechanisms to limit depth of coagulation, deep tissue injury can occur. A small randomized trial compared APC with heater probe for endoscopic hemostasis in bleeding ulcers and reported no difference in outcomes.18 The APC delivery system is more complex and costly when compared with the standard heater probe and, therefore, is less widely used.
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From Servizio di Gastroenterologia ed Endoscopia Digestiva, ASL NA5, Ospedale Maresca, Torre del Greco, Italy.
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Reprint requests: Livio Cipolletta, MD, Via S. Domenico al Vomero, 24 1-80126 Naples, Italy.
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37/69/90688