Efficacy of polyglycolic acid sheets and fibrin glue for the prevention of post-ELPS bleeding |
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| Authors: | Shinya Sugimoto Tomohito Fuke Daisuke Kobayashi Kohki Ueda Masahiro Sawa Mamika Kaneko Kohei Fukukita Taishi Temma Tatsuma Nomura Nobukazu Fuwa Hiroyuki Yamada |
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| Institution: | 1. Divisions of Gastroenterology, Ise Red Cross Hospital, 471-2, 1, Funae, Ise, Mie 516-8512, Japan;2. Divisions of Otolaryngology-Head and Neck Surgery, Ise Red Cross Hospital, Mie, Japan;3. Divisions of Radiation Oncology, Ise Red Cross Hospital, Mie, Japan;1. Department of Otolaryngology, Head and Neck Surgery, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295, Japan;2. Department of Hematology, Clinical Immunology and Infectious Disease, Ehime University Graduate School of Medicine, Toon, Japan;1. Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan;2. Department of Otolaryngology - Head and Neck Surgery, Shizuoka City Hospital, 10-93 Ohte-machi, Aoi-ku, Shizuoka, 420-8630, Japan;3. Department of Otolaryngology - Head and Neck Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 420-8527, Japan |
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| Abstract: | ObjectiveTo assess the efficacy and safety of a covering method using polyglycolic acid (PGA) sheets and fibrin glue in preventing laryngopharyngeal bleeding after endoscopic laryngopharyngeal surgery (ELPS) combined with endoscopic submucosal dissection (ESD).MethodsTwenty-one patients who underwent ELPS combined with ESD (28 resected pharyngeal carcinomas) were retrospectively evaluated. After completing ELPS combined with ESD, fibrinogen was sprayed onto the ulcer. A PGA sheet cut into 5 × 5 mm pieces that fit the size of the ELPS-induced ulcer was then placed over the ulcer and fixed in place with a fibrin glue comprising thrombin.ResultsThe resection procedure was performed for all lesions. The median long diameter of the resected specimen was 36 mm. The rate of a resected specimen diameter >30 mm, use of anticoagulant/platelet, and macroscopic classification 0-Ⅱa were 68% (19/28), 19% (5/28), and 36% (10/28), respectively. The median time required to cover ELPS-induced ulcers using PGA sheets and fibrin glue was 10 min (range: 3–22 min). No post-ELPS bleeding, subcutaneous emphysema, or aspiration pneumonia (0/28) was observed.ConclusionThe covering method using PGA sheets and fibrin glue for ELPS-induced ulcers is considered to be sufficiently safe and effective in preventing post-ELPS laryngopharyngeal bleeding. This method could be useful in preventing post-ELPS bleeding in patients with head and neck cancer. |
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