Clinical Endoscopy

Review

Endoscopic activity in inflammatory bowel disease: clinical significance and application in practice: Kyeong Ok Kim; Clin Endosc 2022;55(4):480-488. Published online July 28, 2022; DOI: https://doi.org/10.5946/ce.2022.108

Endoscopy is vital for diagnosing, assessing treatment response, and monitoring surveillance in patients with inflammatory bowel disease (IBD). With the growing importance of mucosal healing as a treatment target, the assessment of disease activity by endoscopy has been accepted as the standard of care for IBD. There are many endoscopic activity indices for facilitating standardized reporting of the gastrointestinal mucosal appearance in IBD, and each index has its strengths and weaknesses. Although most endoscopic indices do not have a clear-cut validated definition, endoscopic remission or mucosal healing is associated with favorable outcomes, such as a decreased risk of relapse. Therefore, experts suggest utilizing endoscopic indices for monitoring disease activity and optimizing treatment to achieve remission. However, the regular monitoring of endoscopic activity is limited in practice owing to several factors, such as the complexity of the procedure, time consumption, inter-observer variability, and lack of a clear-cut, validated definition of endoscopic response or remission. Although experts have recently suggested consensus-based definitions, further studies are needed to define the values that can predict long-term outcomes.

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Original Articles

The Additive Effect of Platelet-Rich Plasma in the Treatment of Actively Bleeding Peptic Ulcer: Waseem M. Seleem, Amr Shaaban Hanafy; Clin Endosc 2021;54(6):864-871. Published online May 25, 2021; DOI: https://doi.org/10.5946/ce.2021.004

Abstract PDF PubReader ePub

Background
/Aims: Peptic ulcer bleeding is the most common cause of upper gastrointestinal tract bleeding. Platelet-rich plasma (PRP) enhances tissue repair, and is therefore used in various medical treatments. A combination of mechanical or electrothermal hemostasis has been recommended for upper gastrointestinal tract bleeding treatment. This study evaluated the additive efficacy of PRP in bleeding peptic ulcer hemostasis and recovery.
Methods
Eighty patients with peptic ulcer bleeding were initially treated by hemoclipping, and were randomly chosen for either additional PRP (n=40) or additional epinephrine (n=40) injections. Both groups were compared with regard to achieving hemostasis and the frequency of complications.
Results
Hemostasis was immediately achieved in both groups. Two patients (5%) in the PRP group and 8 (20%) patients in the epinephrine group experienced rebleeding after 15.9±2.8 and 12.3±3.7 days, respectively. They were managed by PRP injection in addition to proton pump inhibitor infusion. Hemoglobin was substantially increased in the PRP-treated group with full recovery occurring in 60.5% compared to 31.3% of patients in the epinephrine group (p=0.001). There was no recurrent bleeding in the PRP group, but 4/32 (12.5%) patients in the epinephrine group exhibited rebleeding.
Conclusions
PRP showed additional benefit in reducing peptic ulcer bleeding with no reported significant complications. Clinical trial (NCT03733171).

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The impact of submucosal PRP injection on wound healing after endoscopic sinus surgery: a randomized clinical trial
Konstantina Dinaki, Nikolaos Grigoriadis, Ioannis S. Vizirianakis, Jannis Constantinidis, Stefanos Triaridis, Petros Karkos
European Archives of Oto-Rhino-Laryngology.2024; 281(7): 3587. CrossRef

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Effectiveness of Autologous Platelet-Rich Plasma for the Healing of Ulcers after Endoscopic Submucosal Dissection: Eunju Jeong, In kyung Yoo, Ozlem Ozer Cakir, Hee Kyung Kim, Won Hee Kim, Sung Pyo Hong, Joo Young Cho; Clin Endosc 2019;52(5):472-478. Published online May 17, 2019; DOI: https://doi.org/10.5946/ce.2018.152

Abstract PDF PubReader ePub

Background
/Aims: Platelet-rich plasma (PRP) has been used for wound healing in various medical fields. The aim of this study was to evaluate the clinical efficacy and safety of local PRP injections after endoscopic submucosal dissection (ESD).
Methods
Patients were non-randomly divided into the following two groups: (1) control group in which patients were administered only an intravenous proton pump inhibitor (PPI), and (2) a study group in which patients were administered an intravenous PPI and a topical PRP injection. We assessed the reduction in the ulcer area and stage of the ulcer after the procedure (24 hours, 48 hours, and 28 days after endoscopic surgery).
Results
We enrolled 7 study and 7 control patients. In the study group, the rate of ulcer reduction was 59% compared to 52% in the control group (p=0.372), 28 days after ESD. There were 5 patients in the S stage and 2 patients in the H stage in the study group compared to no patient in the S stage and 7 patients in the H stage in the control group (p=0.05), 28 days after ESD. There were no serious complications in either group.
Conclusions
The local injection of PRP is a safe and effective procedure for ulcer healing after ESD.

Citations

Citations to this article as recorded by

Clinical efficacy of blood derivatives on wound healing: A systematic review and network meta‐analysis
Yanhong Wu, Guang Peng, Yuzhi Wang, Jianwu Chen, Bin Zhang, Jianbing Tang, Biao Cheng
International Wound Journal.2024;[Epub] CrossRef
Endoscopic Shielding With Platelet-rich Plasma After Resection Of Large Colorectal Lesions
Vicente Lorenzo-Zúñiga, Vicente Moreno de Vega, Ramón Bartolí
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2021; 31(3): 376. CrossRef
The Additive Effect of Platelet-Rich Plasma in the Treatment of Actively Bleeding Peptic Ulcer
Waseem M. Seleem, Amr Shaaban Hanafy
Clinical Endoscopy.2021; 54(6): 864. CrossRef
Endless Challenges in Overcoming Complications Associated with Endoscopic Submucosal Dissection
Satoshi Ono, Shun Ito, Kenji Ogata
Clinical Endoscopy.2019; 52(5): 395. CrossRef

9,409 View
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