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Open Access 25-04-2024 | Gastrointestinal Cancer | Original Article

Efficacy of Endoscopic Tissue Adhesive in Patients with Gastrointestinal Tumor Bleeding

Authors: Jun Shen, Lingna Ni, Changhong Zhu, Chunying Jiang, Wenyu Zhu, Yanzhi Bi

Published in: Digestive Diseases and Sciences

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Abstract

Background

Gastrointestinal tumors bleeding remains a significantly clinical challenge due to its resistance to conventional endoscopic hemostasis methods. While the efficacy of endoscopic tissue adhesives (ETA) in variceal bleeding has been established, its role in gastrointestinal tumor bleeding (GITB) remains ambiguous.

Aims

This study aims to assess the feasibility and effectiveness of ETA in the treatment of GITB.

Methods

The study enrolled 30 patients with GITB who underwent hemostasis through Histoacryl® tissue glue injection. Hemostasis success rates, ETA-related adverse events, and re-bleeding rates were evaluated.

Results

ETA application achieved successful hemostasis at all tumor bleeding sites, with immediate hemostasis observed in all 30 (100.0%) patients. Among the initially hemostasis cases, 5 patients (17.0%) experienced re-bleeding within 30 days, and the 60 day re-bleeding rate was 20.0% (6/30). Expect for one case of vascular embolism, no adverse events related with ETA application were reported. The 6 month survival was 93%.

Conclusion

ETA demonstrated excellent immediate hemostasis success rate in GITB cases and showed promising outcomes in prevention re-bleeding.
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Literature
1.
go back to reference Arnold M, Abnet CC, Neale RE et al. Global burden of 5 major types of gastrointestinal cancer. Gastroenterology. 2020;159:335-349.e15.CrossRefPubMed Arnold M, Abnet CC, Neale RE et al. Global burden of 5 major types of gastrointestinal cancer. Gastroenterology. 2020;159:335-349.e15.CrossRefPubMed
2.
go back to reference Arnold M, Rutherford MJ, Bardot A et al. Progress in cancer survival, mortality, and incidence in seven high-income countries 1995–2014 (ICBP SURVMARK-2): a population-based study. Lancet Oncol. 2019;20:1493–1505.CrossRefPubMedPubMedCentral Arnold M, Rutherford MJ, Bardot A et al. Progress in cancer survival, mortality, and incidence in seven high-income countries 1995–2014 (ICBP SURVMARK-2): a population-based study. Lancet Oncol. 2019;20:1493–1505.CrossRefPubMedPubMedCentral
4.
go back to reference Pereira J, Phan T. Management of bleeding in patients with advanced cancer. Oncologist. 2004;9:561–570.CrossRefPubMed Pereira J, Phan T. Management of bleeding in patients with advanced cancer. Oncologist. 2004;9:561–570.CrossRefPubMed
5.
go back to reference Johnstone C, Rich SE. Bleeding in cancer patients and its treatment: a review. Ann Palliat Med. 2018;7:265–273.CrossRefPubMed Johnstone C, Rich SE. Bleeding in cancer patients and its treatment: a review. Ann Palliat Med. 2018;7:265–273.CrossRefPubMed
6.
go back to reference Courtney RJ, Paul CL, Sanson-Fisher RW et al. Factors associated with consultation behaviour for primary symptoms potentially indicating colorectal cancer: a cross-sectional study on response to symptoms. BMC Gastroenterol. 2012;12:100.CrossRefPubMedPubMedCentral Courtney RJ, Paul CL, Sanson-Fisher RW et al. Factors associated with consultation behaviour for primary symptoms potentially indicating colorectal cancer: a cross-sectional study on response to symptoms. BMC Gastroenterol. 2012;12:100.CrossRefPubMedPubMedCentral
7.
go back to reference Yanazume S, Karakida N, Higashi R et al. Tumor bleeding requiring intervention and the correlation with anemia in uterine cervical cancer for definitive radiotherapy. Jpn J Clin Oncol. 2018;48:892–899.CrossRefPubMed Yanazume S, Karakida N, Higashi R et al. Tumor bleeding requiring intervention and the correlation with anemia in uterine cervical cancer for definitive radiotherapy. Jpn J Clin Oncol. 2018;48:892–899.CrossRefPubMed
8.
go back to reference Crooks C, Card T, West J. Reductions in 28-day mortality following hospital admission for upper gastrointestinal hemorrhage. Gastroenterology. 2011;141:62–70.CrossRefPubMed Crooks C, Card T, West J. Reductions in 28-day mortality following hospital admission for upper gastrointestinal hemorrhage. Gastroenterology. 2011;141:62–70.CrossRefPubMed
10.
go back to reference Barkun A, Bardou M, Marshall JK. Consensus recommendations for managing patients with nonvariceal upper gastrointestinal bleeding. Ann Intern Med. 2003;139:843–857.CrossRefPubMed Barkun A, Bardou M, Marshall JK. Consensus recommendations for managing patients with nonvariceal upper gastrointestinal bleeding. Ann Intern Med. 2003;139:843–857.CrossRefPubMed
11.
go back to reference Cao D, Guo CH, Liu JW et al. Bleeding after bevacizumab treatment in patients with metastatic colorectal cancer. Tumori. 2015;101:46–51.CrossRefPubMed Cao D, Guo CH, Liu JW et al. Bleeding after bevacizumab treatment in patients with metastatic colorectal cancer. Tumori. 2015;101:46–51.CrossRefPubMed
13.
go back to reference Leblanc S, Vienne A, Dhooge M et al. Early experience with a novel hemostatic powder used to treat upper GI bleeding related to malignancies or after therapeutic interventions (with videos). Gastrointest Endosc. 2013;78:169–175.CrossRefPubMed Leblanc S, Vienne A, Dhooge M et al. Early experience with a novel hemostatic powder used to treat upper GI bleeding related to malignancies or after therapeutic interventions (with videos). Gastrointest Endosc. 2013;78:169–175.CrossRefPubMed
14.
go back to reference Thosani N, Rao B, Ghouri Y et al. Role of argon plasma coagulation in management of bleeding GI tumors: evaluating outcomes and survival. Turk J Gastroenterol. 2014;25:38–42.CrossRefPubMed Thosani N, Rao B, Ghouri Y et al. Role of argon plasma coagulation in management of bleeding GI tumors: evaluating outcomes and survival. Turk J Gastroenterol. 2014;25:38–42.CrossRefPubMed
15.
go back to reference Montanaro L, Arciola CR, Cenni E et al. Cytotoxicity, blood compatibility and antimicrobial activity of two cyanoacrylate glues for surgical use. Biomaterials. 2001;22:59–66.CrossRefPubMed Montanaro L, Arciola CR, Cenni E et al. Cytotoxicity, blood compatibility and antimicrobial activity of two cyanoacrylate glues for surgical use. Biomaterials. 2001;22:59–66.CrossRefPubMed
16.
go back to reference Cheng LF, Wang ZQ, Li CZ et al. Low incidence of complications from endoscopic gastric variceal obturation with butyl cyanoacrylate. Clin Gastroenterol Hepatol. 2010;8:760–766.CrossRefPubMed Cheng LF, Wang ZQ, Li CZ et al. Low incidence of complications from endoscopic gastric variceal obturation with butyl cyanoacrylate. Clin Gastroenterol Hepatol. 2010;8:760–766.CrossRefPubMed
17.
go back to reference Lee KJ, Kim JH, Hahm KB et al. Randomized trial of N-butyl-2-cyanoacrylate compared with injection of hypertonic saline-epinephrine in the endoscopic treatment of bleeding peptic ulcers. Endoscopy. 2000;32:505–511.CrossRefPubMed Lee KJ, Kim JH, Hahm KB et al. Randomized trial of N-butyl-2-cyanoacrylate compared with injection of hypertonic saline-epinephrine in the endoscopic treatment of bleeding peptic ulcers. Endoscopy. 2000;32:505–511.CrossRefPubMed
18.
go back to reference Wang S, Zhang K, Xiao M. Endoscopic obturation with tissue adhesive for bleeding gastric stromal tumor: a case report. J Int Med Res. 2021;49:300060521991355.PubMed Wang S, Zhang K, Xiao M. Endoscopic obturation with tissue adhesive for bleeding gastric stromal tumor: a case report. J Int Med Res. 2021;49:300060521991355.PubMed
19.
go back to reference Wang S. Observation of wound-closure outcomes using tissue adhesive plus metal clip after endoscopic upper gastrointestinal muscularis propria tumor resection. Am J Gastroenterol. 2013;108:623–624.CrossRefPubMed Wang S. Observation of wound-closure outcomes using tissue adhesive plus metal clip after endoscopic upper gastrointestinal muscularis propria tumor resection. Am J Gastroenterol. 2013;108:623–624.CrossRefPubMed
21.
go back to reference Rajoriya N, Forrest EH, Gray J et al. Long-term follow-up of endoscopic Histoacryl glue injection for the management of gastric variceal bleeding. QJM. 2011;104:41–47.CrossRefPubMed Rajoriya N, Forrest EH, Gray J et al. Long-term follow-up of endoscopic Histoacryl glue injection for the management of gastric variceal bleeding. QJM. 2011;104:41–47.CrossRefPubMed
22.
go back to reference Fry LC, Neumann H, Olano C et al. Efficacy, complications and clinical outcomes of endoscopic sclerotherapy with N-butyl-2-cyanoacrylate for bleeding gastric varices. Dig Dis. 2008;26:300–303.CrossRefPubMed Fry LC, Neumann H, Olano C et al. Efficacy, complications and clinical outcomes of endoscopic sclerotherapy with N-butyl-2-cyanoacrylate for bleeding gastric varices. Dig Dis. 2008;26:300–303.CrossRefPubMed
23.
go back to reference Taghavi SA, Eshraghian A, Hamidpour L et al. Endoscopic cyanoacrylate injection for the treatment of bleeding gastric varices: the first Iranian series. Arch Iran Med. 2012;15:157–161.PubMed Taghavi SA, Eshraghian A, Hamidpour L et al. Endoscopic cyanoacrylate injection for the treatment of bleeding gastric varices: the first Iranian series. Arch Iran Med. 2012;15:157–161.PubMed
24.
go back to reference Sugimoto N, Watanabe K, Watanabe K et al. Endoscopic hemostasis for bleeding gastric varices treated by combination of variceal ligation and sclerotherapy with N-butyl-2-cyanoacrylate. J Gastroenterol. 2007;42:52–532.CrossRef Sugimoto N, Watanabe K, Watanabe K et al. Endoscopic hemostasis for bleeding gastric varices treated by combination of variceal ligation and sclerotherapy with N-butyl-2-cyanoacrylate. J Gastroenterol. 2007;42:52–532.CrossRef
25.
go back to reference Huang YH, Yeh HZ, Chen GH et al. Endoscopic treatment of bleeding gastric varices by N-butyl-2-cyanoacrylate (Histoacryl) injection: long-term efficacy and safety. Gastrointest Endosc. 2000;52:160–167.CrossRefPubMed Huang YH, Yeh HZ, Chen GH et al. Endoscopic treatment of bleeding gastric varices by N-butyl-2-cyanoacrylate (Histoacryl) injection: long-term efficacy and safety. Gastrointest Endosc. 2000;52:160–167.CrossRefPubMed
26.
go back to reference Wang YM, Cheng LF, Li N et al. Study of glue extrusion after endoscopic N-butyl-2-cyanoacrylate injection on gastric variceal bleeding. World J Gastroenterol. 2009;15:4945–4951.CrossRefPubMedPubMedCentral Wang YM, Cheng LF, Li N et al. Study of glue extrusion after endoscopic N-butyl-2-cyanoacrylate injection on gastric variceal bleeding. World J Gastroenterol. 2009;15:4945–4951.CrossRefPubMedPubMedCentral
27.
go back to reference Akahoshi T, Hashizume M, Tomikawa M et al. Long-term results of balloon-occluded retrograde transvenous obliteration for gastric variceal bleeding and risky gastric varices: a 10-year experience. J Gastroenterol Hepatol. 2008;23:1702–1709.CrossRefPubMed Akahoshi T, Hashizume M, Tomikawa M et al. Long-term results of balloon-occluded retrograde transvenous obliteration for gastric variceal bleeding and risky gastric varices: a 10-year experience. J Gastroenterol Hepatol. 2008;23:1702–1709.CrossRefPubMed
29.
go back to reference Messmann H, Schaller P, Andus T et al. Effect of programmed endoscopic follow-up examinations on the rebleeding rate of gastric or duodenal peptic ulcers treated by injection therapy: a prospective, randomized controlled trial. Endoscopy. 1998;30:583–589.CrossRefPubMed Messmann H, Schaller P, Andus T et al. Effect of programmed endoscopic follow-up examinations on the rebleeding rate of gastric or duodenal peptic ulcers treated by injection therapy: a prospective, randomized controlled trial. Endoscopy. 1998;30:583–589.CrossRefPubMed
30.
go back to reference Loh DC, Wilson RB. Endoscopic management of refractory gastrointestinal non-variceal bleeding using Histoacryl (N-butyl-2-cyanoacrylate) glue. Gastroenterol Rep (Oxf) 2016;4:232–236.CrossRefPubMed Loh DC, Wilson RB. Endoscopic management of refractory gastrointestinal non-variceal bleeding using Histoacryl (N-butyl-2-cyanoacrylate) glue. Gastroenterol Rep (Oxf) 2016;4:232–236.CrossRefPubMed
31.
go back to reference de Sáenz MRA, Baltar Arias R, Vázquez Rodríguez S et al. N-Butyl-2-cyanoacrylate plug on fundal varix: persistence 3 years after sclerosis. Rev Esp Enferm Dig. 2009;101:212–214. de Sáenz MRA, Baltar Arias R, Vázquez Rodríguez S et al. N-Butyl-2-cyanoacrylate plug on fundal varix: persistence 3 years after sclerosis. Rev Esp Enferm Dig. 2009;101:212–214.
32.
go back to reference Chen WC, Hou MC, Lin HC et al. Bacteremia after endoscopic injection of N-butyl-2-cyanoacrylate for gastric variceal bleeding. Gastrointest Endosc. 2001;54:214–218.CrossRefPubMed Chen WC, Hou MC, Lin HC et al. Bacteremia after endoscopic injection of N-butyl-2-cyanoacrylate for gastric variceal bleeding. Gastrointest Endosc. 2001;54:214–218.CrossRefPubMed
33.
go back to reference Kim J, Chun HJ, Hyun JJ et al. Splenic infarction after cyanoacrylate injection for fundal varices. Endoscopy. 2010;42:E118.CrossRefPubMed Kim J, Chun HJ, Hyun JJ et al. Splenic infarction after cyanoacrylate injection for fundal varices. Endoscopy. 2010;42:E118.CrossRefPubMed
Metadata
Title
Efficacy of Endoscopic Tissue Adhesive in Patients with Gastrointestinal Tumor Bleeding
Authors
Jun Shen
Lingna Ni
Changhong Zhu
Chunying Jiang
Wenyu Zhu
Yanzhi Bi
Publication date
25-04-2024
Publisher
Springer US
Published in
Digestive Diseases and Sciences
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-024-08432-7
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