抗血栓薬継続下ESDの治療成績-PGAフェルト+フィブリン糊被覆法による後出血予防対策-

Background and Study Aims. When performing endoscopic submucosal dissection (ESD) for patients on antithrombotic agents, the frequency of delayed bleeding is expected to increase. Th endoscopic polyglycolic acid (PGA) felt and fibrin glue sealing method could be a new method for prevention of delayed bleeding. Patients and Methods.The safety and efficacy of the endoscopic tissue sealing method with PGA sheets and fibrin glue for the prevention of post-ESD bleeding were examined in 104 patients taking antithrombotic agents. During the study period, 70 patients taking antithrombotic agents did not undergo the sealing method, 36 patients discontinued antithrombotic agents, and 724 patients had not received antithrombotic therapy. Results. Delayed bleeding rates were 3.8% (4/104) in the sealing group, 12.9% (9/70) in the nonsealing group, 8.3% (3/36) in the discontinuation group, and 4.6% (33/724) in the nonantithrombotic therapy group.Thus, the delayed bleeding rate was signific ntly lower in the sealing group than in the nonsealing group and comparable to that in the nonantithrombotic therapy group. Conclusions.This PGA felt and fi rin glue sealing method might become a promising post-ESD bleeding prevention method in patients taking antithrombotic agents (UMIN000013990, UMIN000013993).長崎大学学位論文 学位記番号:博(医歯薬)甲第869号 学位授与年月日:平成28年6月1日Author: Hiroko Fukuda, Naoyuki Yamaguchi, Hajime Isomoto, Kayoko Matsushima, Hitomi Minami, Yuko Akazawa, Ken Ohnita, Fuminao Takeshima, Saburo Shikuwa, and Kazuhiko NakaoCitation: Gastroenterology Research and Practice, 2016, 1457357; 201