Endoscopy 2021; 53(05): 511-516
DOI: 10.1055/a-1218-6089
Innovations and brief communications

Snare-tip soft coagulation is effective and efficient as a first-line modality for treating intraprocedural bleeding during Barrett’s mucosectomy

Sergei Vosko
1  Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, New South Wales, Australia
,
Sunil Gupta
1  Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, New South Wales, Australia
2  Westmead Clinical School, University of Sydney, Sydney, New South Wales, Australia
,
Neal Shahidi
1  Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, New South Wales, Australia
2  Westmead Clinical School, University of Sydney, Sydney, New South Wales, Australia
3  Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
,
Luke F. Hourigan
4  Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
5  Gallipoli Medical Research Institute, School of Medicine, The University of Queensland, Greenslopes Private Hospital, Brisbane, Queensland, Australia
,
W. Arnout van Hattem
1  Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, New South Wales, Australia
,
Iddo Bar-Yishay
1  Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, New South Wales, Australia
,
Scott Schoeman
1  Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, New South Wales, Australia
,
Mayenaaz Sidhu
1  Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, New South Wales, Australia
2  Westmead Clinical School, University of Sydney, Sydney, New South Wales, Australia
,
Nicholas G. Burgess
1  Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, New South Wales, Australia
2  Westmead Clinical School, University of Sydney, Sydney, New South Wales, Australia
,
Eric Y. T. Lee
1  Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, New South Wales, Australia
2  Westmead Clinical School, University of Sydney, Sydney, New South Wales, Australia
,
Michael J. Bourke
1  Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, New South Wales, Australia
2  Westmead Clinical School, University of Sydney, Sydney, New South Wales, Australia
› Author Affiliations


Abstract

Background Intraprocedural bleeding (IPB) during multiband mucosectomy (MBM) for Barrett’s neoplasia can obscure the endoscopic field. Current hemostatic devices may affect procedure continuity and technical success. Snare-tip soft coagulation (STSC) as a first-line therapy for primary hemostasis has not previously been studied in this setting.

Methods Between January 2014 and November 2019, 191 consecutive patients underwent 292 MBM procedures for Barrett’s neoplasia within a prospective observational cohort in two tertiary care centers. A standard MBM technique was performed. IPB was defined as bleeding obscuring the endoscopic field that required intervention. The primary outcome was the technical success and efficacy of STSC.

Results IPB occurred in 63 MBM procedures (21.6 %; 95 % confidence interval 17.3 % – 26.7 %). STSC was attempted as first-line therapy in 51 IPBs, with the remainder requiring alternate therapies because of pooling of blood. STSC achieved hemostasis in 48 cases (94.1 % by per-protocol analysis; 76.2 % by intention-to-treat analysis). No apparatus disassembly was required to perform STSC.

Conclusions STSC is a safe, effective, and efficient first-line hemostatic modality for IPB during MBM for Barrett’s neoplasia.

Supplementary material



Publication History

Received: 27 February 2020

Accepted: 13 July 2020

Publication Date:
13 July 2020 (online)

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