RESUMO
En los últimos años se han producido avances en el manejo de la hemorragia digestiva alta no varicosa que han permitido disminuir la recidiva hemorrágica y la mortalidad. El presente documento de posicionamiento de la Societat Catalana de Digestologia es una actualización de las recomendaciones basadas en la evidencia sobre el manejo de la hemorragia digestiva por úlcera péptica
In recent years there have been advances in the management of non-variceal upper gastrointestinal bleeding that have helped reduce rebleeding and mortality. This document positioning of the Catalan Society of Digestologia is an update of evidence-based recommendations on management of gastrointestinal bleeding peptic ulcer
Assuntos
Humanos , Hemorragia Gastrointestinal/terapia , Úlcera Péptica Hemorrágica/terapia , Padrões de Prática Médica , Prática Clínica Baseada em Evidências , Endoscopia Gastrointestinal , Transtornos da Coagulação Sanguínea/tratamento farmacológico , Prognóstico , Infecções por Helicobacter/tratamento farmacológico , Soluções Esclerosantes/administração & dosagemRESUMO
In recent years there have been advances in the management of non-variceal upper gastrointestinal bleeding that have helped reduce rebleeding and mortality. This document positioning of the Catalan Society of Digestologia is an update of evidence-based recommendations on management of gastrointestinal bleeding peptic ulcer.
Assuntos
Técnicas Hemostáticas , Úlcera Péptica Hemorrágica/terapia , Anti-Inflamatórios não Esteroides/efeitos adversos , Antiulcerosos/uso terapêutico , Anticoagulantes/efeitos adversos , Biomarcadores/sangue , Terapia Combinada , Comorbidade , Contraindicações de Medicamentos , Soluções Cristaloides , Gerenciamento Clínico , Endoscopia Gastrointestinal , Transfusão de Eritrócitos , Eritromicina/uso terapêutico , Infecções por Helicobacter/complicações , Infecções por Helicobacter/tratamento farmacológico , Helicobacter pylori , Humanos , Hipotensão/etiologia , Hipotensão/terapia , Intubação Gastrointestinal , Soluções Isotônicas/uso terapêutico , Cirrose Hepática/complicações , Cirrose Hepática/diagnóstico , Úlcera Péptica Hemorrágica/sangue , Úlcera Péptica Hemorrágica/etiologia , Exame Físico , Recidiva , Fatores de Risco , Vitamina K/uso terapêuticoRESUMO
AIM: To evaluate the rate of adverse events (AEs) during consecutive gastric and duodenal polypectomies in several Spanish centers. METHODS: Polypectomies of protruded gastric or duodenal polyps ≥ 5 mm using hot snare were prospectively included. Prophylactic measures of hemorrhage were allowed in predefined cases. AEs were defined and graded according to the lexicon recommended by the American Society for Gastrointestinal Endoscopy. Patients were followed for 48 h, one week and 1 mo after the procedure. RESULTS: 308 patients were included and a single polypectomy was performed in 205. Only 36 (11.7%) were on prior anticoagulant therapy. Mean polyp size was 15 ± 8.9 mm (5-60) and in 294 cases (95.4%) were located in the stomach. Hemorrhage prophylaxis was performed in 219 (71.1%) patients. Nine patients presented AEs (2.9%), and 6 of them were bleeding (n = 6, 1.9%) (in 5 out of 6 AE, different types of endoscopic treatment were performed). Other 24 hemorrhagic episodes could be managed without any change in the outcome of the endoscopy and, consequently, were considered incidents. We did not find any independent risk factor of bleeding. CONCLUSION: Gastroduodenal polypectomy using prophylactic measures has a rate of AEs small enough to consider this procedure a safe and effective method for polyp resection independently of the polyp size and location.
