Comparison of Injection Sclerothetapy and Laser Photocoagulation for Bleeding Peptic Ulcers

The most widely used endoscopic procedures in the management of patients with bleeding peptic ulcer are at present sclerotherapy and thermal methods. In an attempt to assess the most effective method of achieving hemostasis, we compared injection sclerotherapy and laser photocoagulation in terms of...

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Matična publikacija: Endoscopy
27 (1995), 4 ; str. 291-297
Glavni autori: Pulanić, Roland (-), Vucelić, Boris (Author), Rosandić, Marija Opačić, Milorad, Rustemović, Nadan Krznarić, Željko, Brkić, Tomislav Jokić-Begić, Nataša
Vrsta građe: Članak
Jezik: eng
LEADER 03143naa a2200277uu 4500
008 131105s1995 xx eng|d
022 |a 0013-726X 
035 |a (CROSBI)109254 
040 |a HR-ZaFF  |b hrv  |c HR-ZaFF  |e ppiak 
100 1 |a Pulanić, Roland 
245 1 0 |a Comparison of Injection Sclerothetapy and Laser Photocoagulation for Bleeding Peptic Ulcers /  |c Pulanić, Roland ; Vucelić, Boris ; Rosandić, Marija ; Opačić, Milorad ; Rustemović, Nadan ; Krznarić, Željko ; Brkić, Tomislav ; Jokić-Begić, Nataša ;. 
246 3 |i Naslov na engleskom:  |a Comparison of Injection Sclerotherapy and Laser Photocoagulation for Bleeding Peptic Ulcers 
300 |a 291-297  |f str. 
363 |a 27  |b 4  |i 1995 
520 |a The most widely used endoscopic procedures in the management of patients with bleeding peptic ulcer are at present sclerotherapy and thermal methods. In an attempt to assess the most effective method of achieving hemostasis, we compared injection sclerotherapy and laser photocoagulation in terms of the efficacy of initial hemostasis, rebleeding, need for surgery, mortality, and the appearance of the ulcer after the hemostatic procedure.In this prospective, randomized trial, 160 patients were treated with injection sclerotherapy (1% polidocanol), and 155 patients with laser photocoagulation (Nd:YAG laser) in cases of Forrest I, Forrest IIa, and Forrest IIb hemorrhage. The bleeding activity was classified according to the modified Forrest criteria. Polidocanol injection and Nd:YAG laser photocoagulation were not preceded by epinephrine administration. There were no significant overall differences between the groups in the outcome in terms of definitive hemostasis, rebleeding, urgent surgery, and death (p = 0.487). In the case of the subgroup with Forrest I lesions, laser photocoagulation was more efficacious than sclerotherapy (p = 0.0078), In the Forrest IIa and Forrest IIb subgroups, the two methods were equally effective (p = 0.202 and 0.513 respectively). In the sclerotherapy patients, definitive initial hemostasis in Forrest IIa was achieved in 100%, whereas in the laser group this rate was 92%, with 28% of patients initially developing hemorrhage after one or two laser pulses, Ulcer healing was slower following sclerotherapy than after photocoagulation. Injection sclerotherapy and laser photocoagulation are equally effective in achieving definitive hemostasis in bleeding peptic ulcers, Laser photocoagulation is more efficacious in patients with active bleeding, whereas injection sclerotherapy is more effective in patients with a nonbleeding visible vessel. 
546 |a ENG 
690 |a 3.02 
693 |a bleeding peptic ulcers, hemostasis, endoscopy  |l hrv  |2 crosbi 
693 |a bleeding peptic ulcers, hemostasis, endoscopy  |l eng  |2 crosbi 
700 1 |a Vucelić, Boris  |4 aut 
700 1 |a Rosandić, Marija  |4 aut  |a Opačić, Milorad 
700 1 |a Rustemović, Nadan  |4 aut  |a Krznarić, Željko 
700 1 |a Brkić, Tomislav  |4 aut  |a Jokić-Begić, Nataša ; 
773 0 |t Endoscopy  |x 0013-726X  |g 27 (1995), 4 ; str. 291-297 
942 |c CLA  |t 1.01  |u 1  |z Znanstveni - clanak 
999 |c 305535  |d 305533