Does Tissue Shielding Prevent Bleeding After Endoscopic Submucosal Dissection?

Rates of bleeding were not reduced with endoscopic tissue shielding versus standard care in patients with gastric cancer.

Risk for postprocedure bleeding is increased for patients who undergo endoscopic submucosal dissection (ESD) for gastric cancer, especially among those requiring large resections (≥40 mm) or those taking antithrombotic medications. Endoscopic tissue shielding is a technique in which polyglycolic acid (PGA) sheets, which are used in surgery, are applied with fibrin glue over the ESD site. Prior case series have suggested that endoscopic tissue shielding may decrease post-ESD bleeding.

To further assess the value of endoscopic tissue shielding in this setting, investigators in Japan conducted a prospective, multicenter, open-label, randomized, controlled trial involving 140 patients with high risk for bleeding who were undergoing ESD for gastr…

Reviewing Author

John R. Saltzman, MD

Disclosures

Consultant/Advisory BoardIterative Scopes

Editorial BoardsGastrointestinal Endoscopy; UpToDate

Leadership Positions in Professional SocietiesAmerican College of Gastroenterology (Trustee)

OtherVice President of Medical Affairs, 1Globe Health Institute