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Erschienen in: Surgical Endoscopy 6/2016

20.10.2015 | Review

Endoscopic hemostasis for peptic ulcer bleeding: systematic review and meta-analyses of randomized controlled trials

verfasst von: Felipe Baracat, Eduardo Moura, Wanderley Bernardo, Leonardo Zorron Pu, Ernesto Mendonça, Diogo Moura, Renato Baracat, Edson Ide

Erschienen in: Surgical Endoscopy | Ausgabe 6/2016

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Abstract

Background

Peptic ulcer represents the most common cause of upper gastrointestinal bleeding. Endoscopic therapy can reduce the risks of rebleeding, continued bleeding, need for surgery, and mortality. The objective of this review is to compare the different modalities of endoscopic therapy.

Methods

Studies were identified by searching electronic databases MEDLINE, Embase, Cochrane, LILACS, DARE, and CINAHL. We selected randomized clinical trials that assessed contemporary endoscopic hemostatic techniques. The outcomes evaluated were: initial hemostasis, rebleeding rate, need for surgery, and mortality. The possibility of publication bias was evaluated by funnel plots. An additional analysis was made, including only the higher-quality trials.

Results

Twenty-eight trials involving 2988 patients were evaluated. Injection therapy alone was inferior to injection therapy with hemoclip and with thermal coagulation when evaluating rebleeding and the need for emergency surgery. Hemoclip was superior to injection therapy in terms of rebleeding; there were no statistically significant differences between hemoclip alone and hemoclip with injection therapy. There was considerable heterogeneity in the comparisons between hemoclip and thermal coagulation. There were no statistically significant differences between thermal coagulation and injection therapy, though their combination was superior, in terms of rebleeding, to thermal coagulation alone.

Conclusions

Injection therapy should not be used alone. Hemoclip is superior to injection therapy, and combining hemoclip with an injectate does not improve hemostatic efficacy above hemoclip alone. Thermal coagulation has similar efficacy as injection therapy; combining these appears to be superior to thermal coagulation alone. Therefore, we recommend the application of hemoclips or the combined use of injection therapy with thermal coagulation for the treatment of peptic ulcer bleeding.
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Literatur
1.
Zurück zum Zitat American Society for Gastrointestinal Endoscopy (2004) ASGE Guide line: the role of endoscopy in acute non-variceal upper-GI hemorrhage. Gastrointest Endosc 60:497–504CrossRef American Society for Gastrointestinal Endoscopy (2004) ASGE Guide line: the role of endoscopy in acute non-variceal upper-GI hemorrhage. Gastrointest Endosc 60:497–504CrossRef
2.
Zurück zum Zitat Wilcox CM, Alexander LN, Cotsonis G (1997) A prospective characterization of upper gastrointestinal hemorrhage presenting with hematochezia. Am J Gastroenterol 92:231–235PubMed Wilcox CM, Alexander LN, Cotsonis G (1997) A prospective characterization of upper gastrointestinal hemorrhage presenting with hematochezia. Am J Gastroenterol 92:231–235PubMed
3.
Zurück zum Zitat Yavorski RT, Wong RK, Maydonovitch C, Battin LS, Furnia A, Amundson DE (1995) Analysis of 3,294 cases of upper gastrointestinal bleeding in military medical facilities. Am J Gastroenterol 90:568–573PubMed Yavorski RT, Wong RK, Maydonovitch C, Battin LS, Furnia A, Amundson DE (1995) Analysis of 3,294 cases of upper gastrointestinal bleeding in military medical facilities. Am J Gastroenterol 90:568–573PubMed
4.
Zurück zum Zitat Rockall TA, Logan RF, Devlin HB, Northfield TC (1995) Incidence of and mortality from acute upper gastrointestinal haemorrhage in the United Kingdom. Steering Committee and members of the National Audit of Acute Upper Gastrointestinal Haemorrhage. BMJ 311:222–226CrossRefPubMedPubMedCentral Rockall TA, Logan RF, Devlin HB, Northfield TC (1995) Incidence of and mortality from acute upper gastrointestinal haemorrhage in the United Kingdom. Steering Committee and members of the National Audit of Acute Upper Gastrointestinal Haemorrhage. BMJ 311:222–226CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat Blocksom JM, Tokioka S, Sugawa C (2004) Current therapy for nonvariceal upper gastrointestinal bleeding. Surg Endosc 18:186–192CrossRefPubMed Blocksom JM, Tokioka S, Sugawa C (2004) Current therapy for nonvariceal upper gastrointestinal bleeding. Surg Endosc 18:186–192CrossRefPubMed
6.
Zurück zum Zitat Cappell MS, Friedel D (2008) Initial management of acute upper gastrointestinal bleeding: from initial evaluation up to gastrointestinal endoscopy. Med Clin North Am 92:491–509CrossRefPubMed Cappell MS, Friedel D (2008) Initial management of acute upper gastrointestinal bleeding: from initial evaluation up to gastrointestinal endoscopy. Med Clin North Am 92:491–509CrossRefPubMed
7.
Zurück zum Zitat Kovacs TO (2008) Management of upper gastrointestinal bleeding. Curr Gastroenterol Rep 10:535–542CrossRefPubMed Kovacs TO (2008) Management of upper gastrointestinal bleeding. Curr Gastroenterol Rep 10:535–542CrossRefPubMed
8.
Zurück zum Zitat Gralnek M, Jensen DM, Gorbein J, Kovacs TO, Jutabha R, Freeman ML, King J, Jensen ME, Cheng S, Machicado GA, Smith JA, Randall GM, Sue M (1998) Clinical and economic outcomes of individuals with severe peptic ulcer hemorrhage and nonbleeding visible vessel: an analysis of two prospective clinical trials. Am J Gastroenterol 93:2047–2053CrossRefPubMed Gralnek M, Jensen DM, Gorbein J, Kovacs TO, Jutabha R, Freeman ML, King J, Jensen ME, Cheng S, Machicado GA, Smith JA, Randall GM, Sue M (1998) Clinical and economic outcomes of individuals with severe peptic ulcer hemorrhage and nonbleeding visible vessel: an analysis of two prospective clinical trials. Am J Gastroenterol 93:2047–2053CrossRefPubMed
9.
Zurück zum Zitat Pedroto I, Dinis-Ribeiro M, Ponchon T (2012) Is timely endoscopy the answer for cost-effective management of acute upper gastrointestinal bleeding? Endoscopy 44:721–722CrossRefPubMed Pedroto I, Dinis-Ribeiro M, Ponchon T (2012) Is timely endoscopy the answer for cost-effective management of acute upper gastrointestinal bleeding? Endoscopy 44:721–722CrossRefPubMed
10.
Zurück zum Zitat Blatchford O, Davidson LA, Murray WR, Blatchford M, Pell J (1997) Acute upper gastrointestinal haemorrhage in west of Scotland: case ascertainment study. BMJ 315:510–514CrossRefPubMedPubMedCentral Blatchford O, Davidson LA, Murray WR, Blatchford M, Pell J (1997) Acute upper gastrointestinal haemorrhage in west of Scotland: case ascertainment study. BMJ 315:510–514CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Simoens M, Rutgeerts P (2001) Non-variceal upper gastrointestinal bleeding. Best Pract Res Clin Gastroenterol 15:121–133CrossRefPubMed Simoens M, Rutgeerts P (2001) Non-variceal upper gastrointestinal bleeding. Best Pract Res Clin Gastroenterol 15:121–133CrossRefPubMed
12.
Zurück zum Zitat Bleau BL, Gostout CJ, Sherman KE, Shaw MJ, Harford WV, Keate RF, Bracy WP, Fleischer DE (2002) Recurrent bleeding from peptic ulcer associated with adherent clot: a randomized study comparing endoscopic treatment with medical therapy. Gastrointest Endosc 56:1–6CrossRefPubMed Bleau BL, Gostout CJ, Sherman KE, Shaw MJ, Harford WV, Keate RF, Bracy WP, Fleischer DE (2002) Recurrent bleeding from peptic ulcer associated with adherent clot: a randomized study comparing endoscopic treatment with medical therapy. Gastrointest Endosc 56:1–6CrossRefPubMed
13.
Zurück zum Zitat Sung J (2006) Best endoscopic hemostasis for ulcer bleeding: Is there such a treatment? Gastrointest Endosc 63:774–775CrossRefPubMed Sung J (2006) Best endoscopic hemostasis for ulcer bleeding: Is there such a treatment? Gastrointest Endosc 63:774–775CrossRefPubMed
14.
Zurück zum Zitat Sung JJ, Luo D, Wu JC, Ching JY, Chan FK, Lau JY, Mack S, Ducharme R, Okolo P, Canto M, Kalloo A, Giday SA (2011) Early clinical experience of the safety and effectiveness of Hemospray in achieving hemostasis in patients with acute peptic ulcer bleeding. Endoscopy 43:291–295CrossRefPubMed Sung JJ, Luo D, Wu JC, Ching JY, Chan FK, Lau JY, Mack S, Ducharme R, Okolo P, Canto M, Kalloo A, Giday SA (2011) Early clinical experience of the safety and effectiveness of Hemospray in achieving hemostasis in patients with acute peptic ulcer bleeding. Endoscopy 43:291–295CrossRefPubMed
15.
Zurück zum Zitat Giday SA, Kim Y, Krishnamurty DM et al (2011) Long–term randomized controlled trial of a novel nanopowder hemostatic agent (TC–325) for control of severe arterial upper gastrointestinal bleeding in a porcine model. Endoscopy 43:296–299CrossRefPubMed Giday SA, Kim Y, Krishnamurty DM et al (2011) Long–term randomized controlled trial of a novel nanopowder hemostatic agent (TC–325) for control of severe arterial upper gastrointestinal bleeding in a porcine model. Endoscopy 43:296–299CrossRefPubMed
16.
Zurück zum Zitat Smith LA, Stanley AJ, Bergman JJ, Kiesslich R, Hoffman A, Tjwa ET, Kuipers EJ, von Holstein CS, Oberg S, Brullet E, Schmidt PN, Igbal T, Mangiavillano B, Masci E, Prat F, Morris AJ (2014) Hemospray Application in Nonvariceal Upper Gastrointestinal Bleeding; results of the Survey to Evaluate the Application of Hemospray in the Luminal Tract. J Clin Gastroenterol 48:89–92 Smith LA, Stanley AJ, Bergman JJ, Kiesslich R, Hoffman A, Tjwa ET, Kuipers EJ, von Holstein CS, Oberg S, Brullet E, Schmidt PN, Igbal T, Mangiavillano B, Masci E, Prat F, Morris AJ (2014) Hemospray Application in Nonvariceal Upper Gastrointestinal Bleeding; results of the Survey to Evaluate the Application of Hemospray in the Luminal Tract. J Clin Gastroenterol 48:89–92
17.
Zurück zum Zitat Barkun AN, Toubouti Y, Rahme E, Bardou M (2009) Endoscopic hemostasis in peptic ulcer bleeding for patients with high-risk lesions: a series of meta-analyses. Gastrointest Endosc 69:786–799CrossRefPubMed Barkun AN, Toubouti Y, Rahme E, Bardou M (2009) Endoscopic hemostasis in peptic ulcer bleeding for patients with high-risk lesions: a series of meta-analyses. Gastrointest Endosc 69:786–799CrossRefPubMed
18.
19.
Zurück zum Zitat Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions : explanation and elaboration. J Clin Epidemiol 62(10):1–34CrossRef Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions : explanation and elaboration. J Clin Epidemiol 62(10):1–34CrossRef
21.
Zurück zum Zitat Barkun A, Bardou M, Marshall JK (2003) Consensus recommendations for managing patients with nonvariceal upper gastrointestinal bleeding. Ann Intern Med 139:843–857CrossRefPubMed Barkun A, Bardou M, Marshall JK (2003) Consensus recommendations for managing patients with nonvariceal upper gastrointestinal bleeding. Ann Intern Med 139:843–857CrossRefPubMed
23.
Zurück zum Zitat Jadad AR, Moore RA, Carrol D, Jenkinson C, Reynolds DJM, Gavaghan DJ et al (1996) Assessing the quality of reports on randomized clinical trials: Is blinding necessary? Controlled Clin Trials 17:1–12CrossRefPubMed Jadad AR, Moore RA, Carrol D, Jenkinson C, Reynolds DJM, Gavaghan DJ et al (1996) Assessing the quality of reports on randomized clinical trials: Is blinding necessary? Controlled Clin Trials 17:1–12CrossRefPubMed
25.
Zurück zum Zitat (RevMan) [Computer program]. Version 5.3. Copenhagen: The Nordic Cochrane Center, The Cochrane Collaborations (RevMan) [Computer program]. Version 5.3. Copenhagen: The Nordic Cochrane Center, The Cochrane Collaborations
27.
Zurück zum Zitat Ljubicic N, Budimir I, Biscanin A, Nikolic M, Supanc V, Hrabar D, Pavic T (2012) Endoclips vs large or small-volume epinephrine in peptic ulcer recurrent bleeding. World J Gastroenterol 18:2219–2224CrossRefPubMedPubMedCentral Ljubicic N, Budimir I, Biscanin A, Nikolic M, Supanc V, Hrabar D, Pavic T (2012) Endoclips vs large or small-volume epinephrine in peptic ulcer recurrent bleeding. World J Gastroenterol 18:2219–2224CrossRefPubMedPubMedCentral
28.
Zurück zum Zitat Jubicic L, Supanc V, Vrsalovic M (2004) Efficacy of endoscopic clipping for actively bleeding peptic ulcer: comparison with polidocanol injection therapy. Hepatogastroenterology 51(56):408–412 Jubicic L, Supanc V, Vrsalovic M (2004) Efficacy of endoscopic clipping for actively bleeding peptic ulcer: comparison with polidocanol injection therapy. Hepatogastroenterology 51(56):408–412
29.
Zurück zum Zitat Shimoda R, Iwakiri R, Sakata H, Ogata S, Kikkawa A, Ootani H, Oda K, Ootani A, Tsunada S, Fujimoto K (2003) Evaluation of endoscopic hemostasis with metallic hemoclips for bleeding gastric ulcer: comparison with endoscopic injection of absolute ethanol in a prospective, randomized study. Am J Gastroenterol 98(10):2198–2202CrossRefPubMed Shimoda R, Iwakiri R, Sakata H, Ogata S, Kikkawa A, Ootani H, Oda K, Ootani A, Tsunada S, Fujimoto K (2003) Evaluation of endoscopic hemostasis with metallic hemoclips for bleeding gastric ulcer: comparison with endoscopic injection of absolute ethanol in a prospective, randomized study. Am J Gastroenterol 98(10):2198–2202CrossRefPubMed
30.
Zurück zum Zitat Chou YC, Hsu PI, Lai KH, Lo CC, Chan HH, Lin CP, Chen WC, Shie CB, Wang EM, Chou NH, Chen W, Lo GH (2003) A prospective, randomized trial of endoscopic hemoclip placement and distilled water injection for treatment of high-risk bleeding ulcers. Gastrointest Endosc 57(3):324–328CrossRefPubMed Chou YC, Hsu PI, Lai KH, Lo CC, Chan HH, Lin CP, Chen WC, Shie CB, Wang EM, Chou NH, Chen W, Lo GH (2003) A prospective, randomized trial of endoscopic hemoclip placement and distilled water injection for treatment of high-risk bleeding ulcers. Gastrointest Endosc 57(3):324–328CrossRefPubMed
31.
Zurück zum Zitat Gevers AM, De Goede E, Simoens M, Hiele M, Rutgeerts P (2002) A randomized trial comparing injection therapy with hemoclip and with injection combined with hemoclip for bleeding ulcers. Gastrointest Endosc 55(4):466–469CrossRefPubMed Gevers AM, De Goede E, Simoens M, Hiele M, Rutgeerts P (2002) A randomized trial comparing injection therapy with hemoclip and with injection combined with hemoclip for bleeding ulcers. Gastrointest Endosc 55(4):466–469CrossRefPubMed
32.
Zurück zum Zitat Chung IK, Ham JS, Kim HS, Park SH, Lee MH, Kim SJ (1999) Comparison of the hemostatic efficacy of the endoscopic hemoclip method with hypertonic saline-epinephrine injection and a combination of the two for the management of bleeding peptic ulcers. Gastrointest Endosc 49(1):13–18CrossRefPubMed Chung IK, Ham JS, Kim HS, Park SH, Lee MH, Kim SJ (1999) Comparison of the hemostatic efficacy of the endoscopic hemoclip method with hypertonic saline-epinephrine injection and a combination of the two for the management of bleeding peptic ulcers. Gastrointest Endosc 49(1):13–18CrossRefPubMed
33.
Zurück zum Zitat Grgov S, Radovanović-Dinić B, Tasić T (2013) Could application of epinephrine improve hemostatic efficacy of hemoclips for bleeding peptic ulcers? A prospective randomized study. Vojnosanit Pregl 70(9):824–829CrossRefPubMed Grgov S, Radovanović-Dinić B, Tasić T (2013) Could application of epinephrine improve hemostatic efficacy of hemoclips for bleeding peptic ulcers? A prospective randomized study. Vojnosanit Pregl 70(9):824–829CrossRefPubMed
34.
Zurück zum Zitat Lo CC, Hsu PI, Lo GH, Lin CK, Chan HH, Tsai WL, Chen WC, Wu CJ, Yu HC, Cheng JS, Lai KH (2006) Comparison of hemostatic efficacy for epinephrine injection alone and injection combined with hemoclip therapy in treating high-risk bleeding ulcers. Gastrointest Endosc 63(6):767–773CrossRefPubMed Lo CC, Hsu PI, Lo GH, Lin CK, Chan HH, Tsai WL, Chen WC, Wu CJ, Yu HC, Cheng JS, Lai KH (2006) Comparison of hemostatic efficacy for epinephrine injection alone and injection combined with hemoclip therapy in treating high-risk bleeding ulcers. Gastrointest Endosc 63(6):767–773CrossRefPubMed
35.
Zurück zum Zitat Arima S, Sakata Y, Ogata S, Tominaga N, Tsuruoka N, Mannen K, Shiraishi R, Shimoda R, Tsunada S, Sakata H, Iwakiri R, Fujimoto K (2010) Evaluation of hemostasis with soft coagulation using endoscopic hemostatic forceps in comparison with metallic hemoclips for bleeding gastric ulcers: a prospective, randomized trial. J Gastroenterol 45(5):501–505CrossRefPubMed Arima S, Sakata Y, Ogata S, Tominaga N, Tsuruoka N, Mannen K, Shiraishi R, Shimoda R, Tsunada S, Sakata H, Iwakiri R, Fujimoto K (2010) Evaluation of hemostasis with soft coagulation using endoscopic hemostatic forceps in comparison with metallic hemoclips for bleeding gastric ulcers: a prospective, randomized trial. J Gastroenterol 45(5):501–505CrossRefPubMed
36.
Zurück zum Zitat Taghavi SA, Soleimani SM, Hosseini-Asl SM, Eshraghian A, Eghbali H, Dehghani SM, Ahmadpour B, Saberifiroozi M (2009) Adrenaline injection plus argon plasma coagulation versus adrenaline injection plus hemoclips for treating high-risk bleeding peptic ulcers: a prospective, randomized trial. Can J Gastroenterol 23(10):699–704CrossRefPubMedPubMedCentral Taghavi SA, Soleimani SM, Hosseini-Asl SM, Eshraghian A, Eghbali H, Dehghani SM, Ahmadpour B, Saberifiroozi M (2009) Adrenaline injection plus argon plasma coagulation versus adrenaline injection plus hemoclips for treating high-risk bleeding peptic ulcers: a prospective, randomized trial. Can J Gastroenterol 23(10):699–704CrossRefPubMedPubMedCentral
37.
Zurück zum Zitat Lin HJ, Perng CL, Sun IC, Tseng GY (2003) Endoscopic haemoclip versus heater probe thermocoagulation plus hypertonic saline-epinephrine injection for peptic ulcer bleeding. Dig Liver Dis 35(12):898–902CrossRefPubMed Lin HJ, Perng CL, Sun IC, Tseng GY (2003) Endoscopic haemoclip versus heater probe thermocoagulation plus hypertonic saline-epinephrine injection for peptic ulcer bleeding. Dig Liver Dis 35(12):898–902CrossRefPubMed
38.
Zurück zum Zitat Lin HJ, Hsieh YH, Tseng GY, Perng CL, Chang FY, Lee SD (2002) A prospective, randomized trial of endoscopic hemoclip versus heater probe thermocoagulation for peptic ulcer bleeding. Am J Gastroenterol 97(9):2250–2254CrossRefPubMed Lin HJ, Hsieh YH, Tseng GY, Perng CL, Chang FY, Lee SD (2002) A prospective, randomized trial of endoscopic hemoclip versus heater probe thermocoagulation for peptic ulcer bleeding. Am J Gastroenterol 97(9):2250–2254CrossRefPubMed
39.
Zurück zum Zitat Cipolletta L, Bianco MA, Marmo R, Rotondano G, Piscopo R, Vingiani AM, Meucci C (2001) Endoclips versus heater probe in preventing early recurrent bleeding from peptic ulcer: a prospective and randomized trial. Gastrointest Endosc 53(2):147–151CrossRefPubMed Cipolletta L, Bianco MA, Marmo R, Rotondano G, Piscopo R, Vingiani AM, Meucci C (2001) Endoclips versus heater probe in preventing early recurrent bleeding from peptic ulcer: a prospective and randomized trial. Gastrointest Endosc 53(2):147–151CrossRefPubMed
40.
Zurück zum Zitat Skok P, Krizman I, Skok M (2004) Argon plasma coagulation versus injection sclerotherapy in peptic ulcer hemorrhage - a prospective, controlled study. Hepatogastroenterology 51(55):165–170PubMed Skok P, Krizman I, Skok M (2004) Argon plasma coagulation versus injection sclerotherapy in peptic ulcer hemorrhage - a prospective, controlled study. Hepatogastroenterology 51(55):165–170PubMed
41.
Zurück zum Zitat Laine L, Estrada R (2002) Randomized trial of normal saline solution injection versus bipolar electrocoagulation for treatment of patients with high-risk bleeding ulcers: is local tamponade enough? Gastrointest Endosc 55(1):6–10CrossRefPubMed Laine L, Estrada R (2002) Randomized trial of normal saline solution injection versus bipolar electrocoagulation for treatment of patients with high-risk bleeding ulcers: is local tamponade enough? Gastrointest Endosc 55(1):6–10CrossRefPubMed
42.
Zurück zum Zitat Lin HJ, Tseng GY, Perng CL, Lee FY, Chang FY, Lee SD (1999) Comparison of adrenaline injection and bipolar electrocoagulation for the arrest of peptic ulcer bleeding. Gut 44(5):715–719CrossRefPubMedPubMedCentral Lin HJ, Tseng GY, Perng CL, Lee FY, Chang FY, Lee SD (1999) Comparison of adrenaline injection and bipolar electrocoagulation for the arrest of peptic ulcer bleeding. Gut 44(5):715–719CrossRefPubMedPubMedCentral
43.
Zurück zum Zitat Gralnek IM, Jensen DM, Kovacs TO, Jutabha R, Jensen ME, Cheng S, Gornbein J, Freeman ML, Machicado GA, Smith J, Sue M, Kominski G (1997) An economic analysis of patients with active arterial peptic ulcer hemorrhage treated with endoscopic heater probe, injection sclerosis, or surgery in a prospective, randomized trial. Gastrointest Endosc 46(2):105–112CrossRefPubMed Gralnek IM, Jensen DM, Kovacs TO, Jutabha R, Jensen ME, Cheng S, Gornbein J, Freeman ML, Machicado GA, Smith J, Sue M, Kominski G (1997) An economic analysis of patients with active arterial peptic ulcer hemorrhage treated with endoscopic heater probe, injection sclerosis, or surgery in a prospective, randomized trial. Gastrointest Endosc 46(2):105–112CrossRefPubMed
44.
Zurück zum Zitat Llach J, Bordas JM, Salmerón JM, Panés J, García-Pagán JC, Feu F, Navasa M, Mondelo F, Piqué JM, Mas A, Terés J, Rodés J (1996) A prospective randomized trial of heater probe thermocoagulation versus injection therapy in peptic ulcer hemorrhage. Gastrointest Endosc 43:117–120CrossRefPubMed Llach J, Bordas JM, Salmerón JM, Panés J, García-Pagán JC, Feu F, Navasa M, Mondelo F, Piqué JM, Mas A, Terés J, Rodés J (1996) A prospective randomized trial of heater probe thermocoagulation versus injection therapy in peptic ulcer hemorrhage. Gastrointest Endosc 43:117–120CrossRefPubMed
45.
Zurück zum Zitat Choudari CP, Rajgopal C, Palmer KR (1992) Comparison of endoscopic injection therapy versus the heater probe in major peptic ulcer haemorrhage. Gut 33(9):1159–1161CrossRefPubMedPubMedCentral Choudari CP, Rajgopal C, Palmer KR (1992) Comparison of endoscopic injection therapy versus the heater probe in major peptic ulcer haemorrhage. Gut 33(9):1159–1161CrossRefPubMedPubMedCentral
46.
Zurück zum Zitat Panés J, Viver J, Forné M (1991) Randomized comparison of endoscopic microwave coagulation and endoscopic sclerosis in the treatment of bleeding peptic ulcers. Gastrointest Endosc 37(6):611–616CrossRefPubMed Panés J, Viver J, Forné M (1991) Randomized comparison of endoscopic microwave coagulation and endoscopic sclerosis in the treatment of bleeding peptic ulcers. Gastrointest Endosc 37(6):611–616CrossRefPubMed
47.
Zurück zum Zitat Waring JP, Sanowski RA, Sawyer RL, Woods CA, Foutch PG (1991) A randomized comparison of multipolar electrocoagulation and injection sclerosis for the treatment of bleeding peptic ulcer. Gastrointest Endosc 37(3):295–298CrossRefPubMed Waring JP, Sanowski RA, Sawyer RL, Woods CA, Foutch PG (1991) A randomized comparison of multipolar electrocoagulation and injection sclerosis for the treatment of bleeding peptic ulcer. Gastrointest Endosc 37(3):295–298CrossRefPubMed
48.
Zurück zum Zitat Chung SC, Leung JW, Sung JY, Lo KK, Li AK (1991) Injection or heat probe for bleeding ulcer. Gastroenterology 100(1):33–37PubMed Chung SC, Leung JW, Sung JY, Lo KK, Li AK (1991) Injection or heat probe for bleeding ulcer. Gastroenterology 100(1):33–37PubMed
49.
Zurück zum Zitat Sollano JD, Ang VN, Moreno JA (1991) Endoscopic hemostasis of bleeding peptic ulcers: 1:10000 adrenalin injection vs. 1:10000 adrenalin +1% aethoxysclerol injection vs. heater probe. Gastroenterol Jpn 26(3):83–85PubMed Sollano JD, Ang VN, Moreno JA (1991) Endoscopic hemostasis of bleeding peptic ulcers: 1:10000 adrenalin injection vs. 1:10000 adrenalin +1% aethoxysclerol injection vs. heater probe. Gastroenterol Jpn 26(3):83–85PubMed
50.
Zurück zum Zitat Laine L (1990) Multipolar electrocoagulation versus injection therapy in the treatment of bleeding peptic ulcers. A prospective, randomized trial. Gastroenterology 99(5):1303–1306PubMed Laine L (1990) Multipolar electrocoagulation versus injection therapy in the treatment of bleeding peptic ulcers. A prospective, randomized trial. Gastroenterology 99(5):1303–1306PubMed
51.
Zurück zum Zitat Lin HJ, Lee FY, Kang WM, Tsai YT, Lee SD, Lee CH (1990) Heat probe thermocoagulation and pure alcohol injection in massive peptic ulcer haemorrhage: a prospective, randomised controlled trial. Gut 31(7):753–757CrossRefPubMedPubMedCentral Lin HJ, Lee FY, Kang WM, Tsai YT, Lee SD, Lee CH (1990) Heat probe thermocoagulation and pure alcohol injection in massive peptic ulcer haemorrhage: a prospective, randomised controlled trial. Gut 31(7):753–757CrossRefPubMedPubMedCentral
52.
Zurück zum Zitat Lin HJ, Tsai YT, Lee SD, Lai KH, Lee FY, Lin CY, Lee CH (1988) A prospectively randomized trial of heat probe thermocoagulation versus pure alcohol injection in nonvariceal peptic ulcer hemorrhage. Am J Gastroenterol 83(3):283–286PubMed Lin HJ, Tsai YT, Lee SD, Lai KH, Lee FY, Lin CY, Lee CH (1988) A prospectively randomized trial of heat probe thermocoagulation versus pure alcohol injection in nonvariceal peptic ulcer hemorrhage. Am J Gastroenterol 83(3):283–286PubMed
53.
Zurück zum Zitat Bianco MA, Rotondano G, Marmo R, Piscopo R, Orsini L, Cipolletta L (2004) Combined epinephrine and bipolar probe coagulation vs. bipolar probe coagulation alone for bleeding peptic ulcer: a randomized, controlled trial. Gastrointest Endosc 60(6):910–915CrossRefPubMed Bianco MA, Rotondano G, Marmo R, Piscopo R, Orsini L, Cipolletta L (2004) Combined epinephrine and bipolar probe coagulation vs. bipolar probe coagulation alone for bleeding peptic ulcer: a randomized, controlled trial. Gastrointest Endosc 60(6):910–915CrossRefPubMed
54.
Zurück zum Zitat Chung SS, Lau JY, Sung JJ, Chan AC, Lai CW, Ng EK, Chan FK, Yung MY, Li AK (1997) Randomised comparison between adrenaline injection alone and adrenaline injection plus heat probe treatment for actively bleeding ulcers. BMJ 314(7090):1307–1311CrossRefPubMedPubMedCentral Chung SS, Lau JY, Sung JJ, Chan AC, Lai CW, Ng EK, Chan FK, Yung MY, Li AK (1997) Randomised comparison between adrenaline injection alone and adrenaline injection plus heat probe treatment for actively bleeding ulcers. BMJ 314(7090):1307–1311CrossRefPubMedPubMedCentral
55.
Zurück zum Zitat Lu Y, Chen YI, Barkun A (2014) Endoscopic Management of Acute Peptic Ulcer Bleeding. Gastroenterol Clin North Am 43(4):677–705CrossRefPubMed Lu Y, Chen YI, Barkun A (2014) Endoscopic Management of Acute Peptic Ulcer Bleeding. Gastroenterol Clin North Am 43(4):677–705CrossRefPubMed
56.
Zurück zum Zitat Laine L, McQuaid KR (2009) Endoscopic therapy for bleeding ulcers: an evidence-based approach based on meta-analyses of randomized controlled trials. Clin Gastroenterol Hepatol 7(1):33–47CrossRefPubMed Laine L, McQuaid KR (2009) Endoscopic therapy for bleeding ulcers: an evidence-based approach based on meta-analyses of randomized controlled trials. Clin Gastroenterol Hepatol 7(1):33–47CrossRefPubMed
57.
Zurück zum Zitat Calvet X, Vergara M, Brullet E (2004) Addition of a second endoscopic treatment following epinephrine injection improves outcome in high-risk bleeding ulcers. Gastroenterology 126(2):441–450CrossRefPubMed Calvet X, Vergara M, Brullet E (2004) Addition of a second endoscopic treatment following epinephrine injection improves outcome in high-risk bleeding ulcers. Gastroenterology 126(2):441–450CrossRefPubMed
58.
Zurück zum Zitat Moher D, Liberati A, Tetzlaff J, Altman DG (2009) The PRISMA Group. Preferred Reporting Items for Systematic Reviews and Meta-Analyses, The PRISMA Statement Moher D, Liberati A, Tetzlaff J, Altman DG (2009) The PRISMA Group. Preferred Reporting Items for Systematic Reviews and Meta-Analyses, The PRISMA Statement
Metadaten
Titel
Endoscopic hemostasis for peptic ulcer bleeding: systematic review and meta-analyses of randomized controlled trials
verfasst von
Felipe Baracat
Eduardo Moura
Wanderley Bernardo
Leonardo Zorron Pu
Ernesto Mendonça
Diogo Moura
Renato Baracat
Edson Ide
Publikationsdatum
20.10.2015
Verlag
Springer US
Erschienen in
Surgical Endoscopy / Ausgabe 6/2016
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-015-4542-x

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S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

CME: 2 Punkte

Prof. Dr. med. Gregor Antoniadis Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

CME: 2 Punkte

Dr. med. Benjamin Meyknecht, PD Dr. med. Oliver Pieske Das Webinar S2e-Leitlinie „Distale Radiusfraktur“ beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

CME: 2 Punkte

Dr. med. Mihailo Andric
Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.