Combined Use of Biologically Active Hemostatic and Granulated Sorbent in Endoscopic Cytoprotective Hemostasis in Patients with Bleeding Gastroduodenal Ulcers

Abstract

Background: The treatment of ulcerative gastroduodenal bleeding (GDB) remains one of the most acute problems in emergency surgery. The aim of our research was to improve the results of treatment of patients with bleeding gastroduodenal ulcers (GDUs) through the use of endoscopic pneumatic applications of platelet-rich auto-plasma (PRAP) and the cytoprotective sorbent Aseptisorb-A. Methods and Results: The study included 112 patients with bleeding GDUs. All patients were divided, by random sampling, into two equivalent groups: the main group (MG, n=57) and the comparison group (CG, n=55). In the treatment of MG patients, an individual approach was applied that used Aseptisorb-A and biologically active hemostatic agent PRAP in the complex endoscopic treatment of GDU complicated by bleeding. In CG, traditional methods of endoscopic hemostasis (EH) were used without PRAP and granular sorbents. After that, complex treatment of patients in the MG and CG did not differ. The relapse rate and operational activity was 3.5% in the MG and 10.9% in the CG (P=0.04); mortality rate was 1.75% in the MG and 5.45% in the CG; the duration of inpatient treatment in the MG and the CG was noted within 6.0(5.0;7.0) and 9.0(8.0;10.0) days, respectively (P<0.01). Conclusion: The developed method for treatment of ulcerative GDB with the combined use the cytoprotective sorbent Aseptisorb-A and a biologically active hemostatic agent PRAP, for the reliability of EH, reduces the number of emergency operations by 2.6 times, mainly due to a decrease in the number of rebleedings and, as a consequence, leads to a decrease in postoperative mortality by 3.1 times.

Keywords

• bleeding gastroduodenal ulcers
• endoscopic hemostasis
• cytoprotective sorbents
• hemostatic agent
• platelet-rich auto-plasma