Author/Editor		Skok, Pavel; Čeranič, Davorin; Sinkovič, Andreja; Pocajt, Milan
Title		Krvaveča peptična razjeda: primerjava učinkovitosti argonske plazemske koagulacije in injekcijskega sklerozacijskega zdravljenja pri nujni endoskopiji - prospektivna, randomizirana, kontrolirana raziskava
Translated title		Bleeding peptic ulcer: comparison of argon plasma coagulation and injection sclerotherapy in emergency endoscopy - a prospective, randomised, controlled study
Type		članek
Source		In: Bručan A, Gričar M, editors. Urgentna medicina: izbrana poglavja 6. Zbornik 7. mednarodni simpozij o urgentni medicini; 2000 jun 14-17; Portorož. Ljubljana: Slovensko združenje za urgentno medicino,
Publication year		2000
Volume		str. 313-20
Language		eng
Abstract		Background. Peptic ulcer is the most common cause of acute upper digestive tract hemorrhage, accounting for about half the cases. Study aims. To evaluate the efficacy of argon plasma coagulation (APC) and injection sclerotherapy (IS) in bleeding peptic ulcer. Study design. A prospective, controlled, randomized study. Patients and Methods. The study includes 80 patients with peptic ulcer hemorrhage (male 50, female 30, av.age 57,5 years, SD+-16, span 28-84; gastric ulcer 40 patients, duodenal ulcer 40 patients) in the period between 1.01. 1999 and 1.03. 2000. The bleeding activity was determined according to Forrest classification. Fourty patients were randomized to receive APC (group A) and in fourty patients (group B) IS was performed (sclerosing with diluted adrenalin 1:10,000 plus polidocanol 1%). The groups did not differ with respect to age, sex, site, severity of bleeding and additional diseases. Results. Clinically and endoscopically diagnosed reebleding occured in 6/40 patients (15%) in group A and in 9/40 patients (22.5%) in group B. The majority of reebleding occured within 48 hours after endoscopic hemostasis, group A 3/6 (50%), group B 6/9 (66.6 %). Repeated endoscopic hemostasis did not prove successtul in 7 patients (group A 3, group B 4). Six patients were treated operatively. The total mortality rate was 10% (8/80 patients, group A 3/40, 7.5%, group B 5/40, 12.5%). Only one patient died from gastrointestinal bleeding, other 7 patients died due to concomitant diseases. Conclusions. Endoscopic hemostasis is a major therapeutic advance in the management of peptic ulcer hemorrhage and has influenced surgical management. Early elective operation after initial endoscopic hemostasis is the wise choice for elderly patients with comorbid disease and selected patients at high risk for recurrent bleeding. Argon plasma coagulation is a promising method of interventional endoscopy. (Abstract truncated at 2000 characters).
Descriptors		PEPTIC ULCER HEMORRHAGE SCLEROSING SOLUTIONS HEMOSTASIS, ENDOSCOPIC RECURRENCE RISK FACTORS LASER COAGULATION ARGON