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Minimally Invasive Therapy & Allied Technologies Volume 31, 2022 - Issue 4
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Original Articles

Wafer paper and ring-mounted polyglycolic acid sheet method for shielding artificial gastric floor

Nobuya Kobayashia Departments of Gastroenterology and Neurology, Kagawa University, Kita, JapanCorrespondence[email protected]
ORCID Iconhttps://orcid.org/0000-0001-9950-3406
ORCID Icon,
Hideki Kobaraa Departments of Gastroenterology and Neurology, Kagawa University, Kita, JapanORCID Iconhttps://orcid.org/0000-0002-8508-827X
ORCID Icon,
Noriko Nishiyamaa Departments of Gastroenterology and Neurology, Kagawa University, Kita, JapanORCID Iconhttps://orcid.org/0000-0003-3707-9317
ORCID Icon,
Shintaro Fujiharaa Departments of Gastroenterology and Neurology, Kagawa University, Kita, Japan
,
Kazuhiro Kozukaa Departments of Gastroenterology and Neurology, Kagawa University, Kita, Japan
,
Naoya Tadaa Departments of Gastroenterology and Neurology, Kagawa University, Kita, Japan
,
Takanori Matsuia Departments of Gastroenterology and Neurology, Kagawa University, Kita, Japan
,
Taiga Chiyoa Departments of Gastroenterology and Neurology, Kagawa University, Kita, Japan
,
Tadayuki Takataa Departments of Gastroenterology and Neurology, Kagawa University, Kita, Japan
,
Koji Fujitaa Departments of Gastroenterology and Neurology, Kagawa University, Kita, Japan
,
Joji Tania Departments of Gastroenterology and Neurology, Kagawa University, Kita, Japan
,
Tatsuo Yachidaa Departments of Gastroenterology and Neurology, Kagawa University, Kita, Japan
,
Keiichi Okanob Gastroenterological Surgery, Kagawa University, Kita, Japan
,
Daisuke Nakanoc Pharmacology, Faculty of Medicine, Kagawa University, Kita, Japan
,
Akira Nishiyamac Pharmacology, Faculty of Medicine, Kagawa University, Kita, Japan
,
Hirohito Moria Departments of Gastroenterology and Neurology, Kagawa University, Kita, Japan
&
Tsutomu Masakia Departments of Gastroenterology and Neurology, Kagawa University, Kita, JapanORCID Iconhttps://orcid.org/0000-0002-8425-0685
ORCID Icon show all
Pages 548-555 | Received 05 Jun 2020, Accepted 22 Dec 2020, Published online: 19 Jan 2021
 
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Abstract

Background

The management of postoperative bleeding, after gastric endoscopic submucosal dissection (ESD), has become particularly important because of the recent increase in antithrombotic use. Endoscopic shielding with polyglycolic acid (PGA) sheets has been shown to be effective. However, shrinkage and early displacement of the sheet remain challenges. This study aimed to determine the efficacy and safety of our developed method, named wafer paper and ring-mounted PGA sheet (WaRP).

Material and methods

Twenty-four patients with antithrombotic uptake who underwent the WaRP method following gastric ESD were retrospectively examined. This involved the delivery of a PGA sheet wrapped in wafer paper with ring-thread, and its fixation on the gastric floor using hemoclips. The primary outcome was the technical success rate of the WaRP, and several secondary outcomes were evaluated.

Results

The technical success rate of WaRP was 100%. The procedure lasted a mean of 10.5 min (SD 6.7 min). The prevalence of complete retention at follow-up endoscopy was 83.3% (20/24). There were no WaRP-associated complications, but post-ESD hemorrhage occurred in two patients undergoing hemodialysis (8.3%).

Conclusions

The WaRP method is a simple and reliable means of PGA sheet delivery and placement that reduces the incidence of post-ESD hemorrhage.

Acknowledgement

The authors thank Mark Cleasby, PhD, of Edanz Group (www.edanzediting.com/ac) for editing a draft of this manuscript.

Ethical approval

The present study was approved by the Clinical Ethics Committee of Kagawa University Hospital (No. 2019-253) and that of each of the other institutions, and was conducted in accordance with the principles of the Declaration of Helsinki. The study is reported according to the STROBE checklist. All patients provided their written informed consent to undergo the procedures and participate in the study.

Declaration of interest

All authors have no conflicts of interest or financial ties to disclose.

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