Feasibility of a modified search, coagulation, and clipping method with and without the use of polyglycolic acid sheets and fibrin glue for preventing delayed bleeding after gastric endoscopic submucosal dissection

Abstract Background Methods have been developed for preventing delayed bleeding (DB) after gastric endoscopic submucosal dissection (GESD). However, none of the methods can completely prevent DB. We hypothesized that DB could be prevented by a modified search, coagulation, and clipping (MSCC) method patients at low risk combining use polyglycolic acid sheets fibrin glue with MSCC (PMSCC method) high (antibleeding [ABI] strategy). This study assessed technical feasibility this novel strategy. Method investigated 123 lesions in 121 consecutive who underwent GESD Kushiro Rosai Hospital between April 2018 January 2020. The decision continuation or cessation antithrombotic agents was based on Guidelines Gastroenterological Endoscopy Patients Undergoing Antithrombotic Treatment. Results Oral were administered to 28 (22.8%). en bloc R0 resection rate 98.4%. PMSCC performed 114 9 lesions, respectively. median time 16 min, speed (the area divided used) 3.6 cm 2 /10 min. 59 1.3 only procedural adverse event 1 (0.8%) lesions. Conclusions ABI strategy is feasible both those GESD, whereas may necessary reduction time.