Fibrin Glue Can Prevent Bleeding After Endoscopic Submucosal Dissection

Objective To explore the utility of fibrin glue in prevention of bleeding after endoscopic submucosal dissection to investigate the risk factors for bleeding after endoscopic submucosal dissection.Methods:330 patients who underwent ESD between July 2015 and June 2016 were enrolled in the study,the patients were divided into two groups,fibrin glue was sprayed in 161 patients of Group A,while 169 patients in group B were treated with routine hemostasis method.bleeding rate after ESD were compared between the two groups.37 patients experienced bleeding after ESD were grouped into bleeding group,the remaining 293 patients were divided into non-bleeding group,several factors were compared between the two groups to analyse the risk factors of bleeding after ESD.Results:Bleeding rate after ESD were lower in group A.(P<0.05).37 patients experienced bleeding after ESD,among whom 22 occurred within 24 hours after ESD,13 within 1 week and 2 after 1 week.Univariate analysis revealed that resection size and procedure time over 120 min are risk factors for bleeding after ESD,preoperative use of anticoagulant or antiplatelet agents is risk factors for bleeding after esophageal ESD.The use of fibrin glue can reduce the bleeding rate after ESD.Multivariate analysis revealed that resection size greater than or equal to 3cm and the absence of fibrin glue are independent risk factor for bleeding after ESD.Conclusions:The use of fibrin glue is safe,effective and economical in the procedure of ESD.resection size greater than or equal to 3cm and the absence of fibrin glue are independent risk factor for bleeding after ESD.So adequate preparation and close monitoring are needed during the procedure of ESD.