Efficacy of human-derived fibrin sealant in preventing postoperative adverse events after gastric endoscopic submucosal dissection: a retrospective multicenter study
摘要
The purpose of this study was to evaluate the efficacy of the human-derived fibrin sealant in mitigating adverse events subsequent to endoscopic submucosal dissection (ESD) for the treatment of gastric mucosal lesions.
MethodsA retrospective analysis was conducted on data from 661 patients who underwent ESD for gastric mucosal lesions with a resected specimen size ≥ 40 mm. These patients were categorized into the fibrin sealant group and the control group on the basis of postoperative wound management strategies. Comparisons were made between the groups regarding the incidence of adverse events and the postoperative wound healing rate at 1 month. Additionally, factors associated with delayed bleeding following ESD were analyzed.
ResultsCompared with the control group, the fibrin sealant group had a significantly lower rate of delayed hemorrhage (1.7% vs. 6.9%; P < 0.001). Subgroup analysis confirmed the consistency of this effect across all the subgroups. Additionally, compared with the control group, the fibrin sealant group had a lower postoperative abdominal pain rate and a lower 24-h postoperative abdominal pain score (P < 0.001). One month after ESD, the fibrin sealant group had a higher wound healing rate (65.4% vs. 51.1%; P = 0.014). Multivariate analysis identified lesions located in the lower one-third of the stomach and specimen size ≥ 60 mm as risk factors for postoperative bleeding.
ConclusionThe application of human-derived fibrin sealant to post-ESD wounds effectively decreased the risk of delayed postoperative hemorrhage, mitigated postoperative abdominal pain, and accelerated the healing process of artificial wounds.