Korean Journal of Gastrointestinal Endoscopy 2004;29(6): 489-494.
소화성 궤양 출혈에서 내시경적 분말 산포제의 효과
백일현ㆍ오흥영ㆍ백광호ㆍ한태호ㆍ김진배ㆍ이 진ㆍ이명석
한림대학교 의과대학 내과학교실
The Effects of Endoscopic Sodium Alginate Powder (Alto ShooterTM) in Peptic Ulcer Bleeding
Ilhyun Baek, M.D., Heung Young Oh, M.D., Gwang Ho Baik, M.D., Taeho Hahn, M.D., Jin Bae Kim, M.D., Jin Lee, M.D. and Myung Seok Lee, M.D.
Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea
Abstract
Background/Aims: Peptic ulcer bleeding can be treated by endoscopic laser, argon plasma coagulation, heater probe, or electrocoagulation. However, techinical difficulties and significant rebleeding rate after such endoscopic hemostasis, offer some beneficial effect of Alto ShooterTM as an adjuvant therapy in active peptic ulcer bleeding. Methods: Twenty-three patients with active peptic ulcer bleeding were randomized to Alto ShooterTM & argon plasma coagulation therapy (ALTOAPC) or argon plasma coagulation therapy alone (APC). Forrest classifications were used to compare the effect of bleeding control. Results: The Forrest classifications in two groups before treatment were Ib (6 patients), IIa (11 patients) in "ALTOAPC", Ib (2 patients) and IIa (4 patients) in "APC". The Forrest classifications of two groups at follow-up endoscopy were Ia (1 patient), Ib (1 patient), IIc (14 patients), III (1 patient) in "ALTOAPC" and IIc (6 patients) in "APC". There was no significant difference in hemostatic effect between "ALTOAPC" (p=0.001) and "APC" (p=0.001) groups. Conclusions: Alto ShooterTM offers no advantage over conventional endoscopic argon plasma coagulation therapy in controlling active peptic ulcer bleeding. Therefore routine addition of Alto ShooterTM treatment may not be recommended after initial successful endoscopic argon plasma coagulation therapy in active peptic ulcer bleeding. (Korean J Gastrointest Endosc 2004;29:489494)
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