Efficacy Of Polyethylene Oxide Hemostatic Powder On Preventing Delayed Bleeding After Endoscopic Submucosal Dissection:a Nonrandomized Controlled Trial

Aim:To evaluate the efficacy and safety of a novel polyethylene oxide hemostatic powder on preventing delayed bleeding after endoscopic submucosal dissection(ESD).Materials and Methods:Patients who were treated by ESD from June,2017 to January 2019 were enrolled in this study.Subjects receiving ESD before 2018,April and willing to use PEO hemostatic powder with informed consents were recruited to hemostatic powder group.Consecutive patients undergoing ESD after March 31,2018 were assigned into control group.Hemostatic powder was applied on post-ESD ulcers after routine hemostasis method in hemostatic powder group,the control group were given routine hemostasis method only.The safety was evaluated after 30 days of follow-up based on the records of complications and laboratory examination.Results:A total of 177 patients and 182 post-ESD ulcers were enrolled.There were 48 patients,49 wounds in hemostatic powder group and 129 patients,133 wounds in control group.There was no delayed bleeding event in hemostatic powder group,while 12 in the control group,the difference was significant.[0.00%(0/49)VS 9.02%(12/133),P?0.038].The mean time to spray powder was 72.18(44?165)s,though delivery catheter was blocked in one case(2.04%).No adverse event was reported during 30-day follow up.In addition,there was no significant difference between the level of alanine aminotransferase,creatinine,platelet count,prothrombin time,partial thromboplastin time and thrombin time in patients with preoperative and postoperative(P>0.05).Conclusions:Although capacity of hemostatic spraying system remains to be improved,polyethylene oxide hemostatic powder is still a effective,safe and simple method to protect post-ESD ulcers,hence the delayed bleeding rate was reduced.