دورية أكاديمية
TC-325 hemostatic powder in the management of upper gastrointestinal malignant bleeding: a randomized controlled trial
| العنوان: | TC-325 hemostatic powder in the management of upper gastrointestinal malignant bleeding: a randomized controlled trial |
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| المؤلفون: | Bruno Costa Martins, Andressa Abnader Machado, Rodrigo Corsato Scomparin, Gustavo Andrade Paulo, Adriana Safatle-Ribeiro, Sebastian Naschold Geiger, Luciano Lenz, Marcelo Simas Lima, Caterina Pennacchi, Ulysses Ribeiro, Alan N. Barkun, Fauze Maluf-Filho |
| المصدر: | Endoscopy International Open, Vol 10, Iss 10, Pp E1350-E1357 (2022) |
| بيانات النشر: | Georg Thieme Verlag KG, 2022. |
| سنة النشر: | 2022 |
| المجموعة: | LCC:Diseases of the digestive system. Gastroenterology |
| مصطلحات موضوعية: | Diseases of the digestive system. Gastroenterology, RC799-869 |
| الوصف: | Background and study aims Upper gastrointestinal bleeding (UGIB) from malignancy is associated with high rebleeding and mortality rates. Recently, TC-325 powder has shown promising results in the treatment of UGIB, including malignant bleeding. The aim of this study was to compare the efficacy of TC-325 versus best clinical management. Patients and methods From August 2016 to February 2020, all patients with evidence of UGIB from malignancy were randomized to receive TC-325 therapy or control group, in which endoscopic treatment was not mandatory. Exclusion criteria were hemoglobin drop without overt bleeding and UGIB from non-tumor origin. The primary outcome was 30-day mortality. Secondary outcomes were 30-day rebleeding, blood transfusion and length of hospital stay. Results Sixty-two patients were randomized, three were excluded and 59 were included in the final analysis (TC-325 group = 28; control = 31). Groups were similar at baseline. Active bleeding was observed in 22 patients in the TC-325 group and 19 in the control group (P = 0.15). Successful initial hemostasis with TC-325 was achieved in all cases. Additional therapy (radiotherapy, surgery or arterial embolization) was equally performed in both groups (42.9 % vs 58.1 %; P = 0.243). There were no differences in 30-day mortality (28.6 % vs. 19.4 %, P = 0.406) or 30-day rebleeding rates (32.1 % vs. 19.4 %, P = 0.26). Logistic regression identified no significant predictors of rebleeding. Age, Eastern Cooperative Oncology Group (ECOG) score 3 to 4 and AIMS65 score > 1 predicted greater mortality. Conclusions TC-325 was effective in achieving immediate hemostasis in malignant gastrointestinal bleeding but did not reduce 30-day mortality, 30-day rebleeding, blood transfusion or length of hospital stay. Age, ECOG 3–4, and AIMS65 > 1 were predictive factors of mortality. |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English |
| تدمد: | 2364-3722 2196-9736 |
| Relation: | https://doaj.org/toc/2364-3722; https://doaj.org/toc/2196-9736 |
| DOI: | 10.1055/a-1906-4769 |
| URL الوصول: | https://doaj.org/article/cb53ed7cc48f4249bc9bfcd2636c5b59 |
| رقم الأكسشن: | edsdoj.b53ed7cc48f4249bc9bfcd2636c5b59 |
| قاعدة البيانات: | Directory of Open Access Journals |
Full Text Finder | تدمد: | 23643722 21969736 |
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| DOI: | 10.1055/a-1906-4769 |