Experimental treatment of gastrointestinal bleeding with endoscopic high-frequency welding bipolar electrocoagulation.

Authors

  • S. O. Oparin Kyiv regional clinical hospital, Ukraine
  • O. O. Dyadyk Shupyk National Medical Academy of Postgraduate Education, Ukraine
  • J. P. Feleshtinsky Shupyk National Medical Academy of Postgraduate Education, Ukraine
  • B. V. Sorokin Shupyk National Medical Academy of Postgraduate Education, Ukraine
  • K. S. Kozlova Shupyk National Medical Academy of Postgraduate Education, Ukraine
  • D. V. Lutsenko Kyiv regional clinical hospital, Ukraine
  • O. V. Gruzinskiy Bila Tserkva District Hospital, Ukraine

DOI:

https://doi.org/10.26641/1997-9665.2018.3.105-110

Keywords:

gastrointestinal bleeding, endoscopic probe, endoscopic hemostasis, pathomorphological studies

Abstract

Background. Problem of treatment of gastrointestinal bleeding remains relevant. According to the Center of Medical Statistics of the Ukraine Health Ministry - total mortality of gastrointestinal bleeding in Ukraine is 5, 87%. In 2017, 18968 patients were hospitalized, of which 35, 56% with late hospitalization (> 24 hours). Mortality of gastrointestinal bleeding in Ukraine is 5, 87%, in Kiev - 7, 42%. Postoperative mortality in Ukraine is 5,15%, late hospitalization (>24h) — 7,86%; in Kyiv - 3,33%, late hospitalization — 6,32%. Endoscopic hemostasis reduces both general and postoperative mortality 3-4 times. There are a number of methods for endoscopic hemostasis: chemical (Caproferr, Infuzol), injectable (Epinephrine 1:20, Terlipressin), monopolar coagulation, argonoplasmic coagulation, laser coagulation, and clapping. Objective. We have proposed endoscopic high-frequency welding bipolar coagulation with a probe (Patented No. 115147, Application number u201608620 dated 10.04.17), which is carried out through the instrumental channel of the endoscope to the bleeding site. Methods. Welding of the vessel is provided by the high-frequency bipolar apparatus EK-300 M1. In order to evaluate the effectiveness of our method we conducted an experiment on pigs with morphological verification of the vessel's condition. We used two different probes for high-frequency welding bipolar coagulation, connected to the EK-300 M1 for welding bleeding vessel. Results. After coagulation visually we could see that bleeding was stopped in all cases. Morphologically was found that for stopping bleeding of vessels up to 1mm in diameter the most effective is the use of a probe 1 with an exposure time of 15s, for vessels more than 1mm is effective to use a probe 2 with an exposure time of 30s. Conclusion. Taking into account the results of our study and disadvantages of already existing methods, high-frequency welding bipolar electrocoagulation has its own advantages (superficial effect on tissue, good coagulation effect with bleeding vessels 2-3mm and more, can be used in patients with artificial pacemaker), therefore it is new expedient and justified method of endoscopic stopping of bleeding.

References

  1. State institution [Center of medical statistics of the Ministry of Health of Ukraine]. Available from:: http://www.medstat.gov.ua. Ukrainian.
  2. Fomin PD, Boiyko BB, Haponov BB, Nikishaev VI. [Methodological recommendations]. Minutes. 2012;5:5-12. Ukrainian.
  3. Vergara M, Bennett C, Calvet X, Gisbert JP. Epinephrine injection versus epinephrine injection and a second endoscopic method in high-risk bleeding ulcers. Cochrane Database Syst Rev. 2014;10:14-5.
  4. Cheng HC, Wu CT, Chen WY, Yang EH, Chen PJ, Sheu BS. Risk factors determining the need for second-look endoscopy for peptic ulcer bleeding after endoscopic hemostasis and proton pump inhibitor infusion. Endosc Int Open. 2016;3:11-8.
  5. Akin M, Alkan E, Tuna Y, Yalcinkaya T, Yildirim B. Comparison of heater probe coagulation and argonplasma coagulation in the management of Mallory-Weiss tearsand high-risk ulcer bleeding. Gastroenterol. 2017;3:52-4.
  6. Ljubicic N, Budimir I, Biscanin A, Nikolic M, Supanc V, Hrabar D, Pavic T. Endoclips vs large or small-volume epinephrine in peptic ulcer recurrent bleeding. World J Gastroenterol. 2012;3:33-4.
  7. Hudetskyy I, Sorokin BV, Oparin SA, Zelnichenkko OT, Oparin OS, inventors. Bipolar radiofrequency probe for minimally invasive endoscopic surgery. Ukraine patent UA 115147. 2010 Apr 17. Ukrainian.

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How to Cite

Oparin, S. O., Dyadyk, O. O., Feleshtinsky, J. P., Sorokin, B. V., Kozlova, K. S., Lutsenko, D. V., & Gruzinskiy, O. V. (2018). Experimental treatment of gastrointestinal bleeding with endoscopic high-frequency welding bipolar electrocoagulation. Морфологія / Morphologia / Morfologìâ, 12(3), 105–110. https://doi.org/10.26641/1997-9665.2018.3.105-110

Issue

Vol. 12 No. 3 (2018)

Section

Статті

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