Endoscopic Treatment of Major Bleeding From Advanced Gastroduodenal Malignant Lesions
To summarize the results of endoscopic therapy for acute hemorrhage from gastroduodenal malignant lesions. The 3-year experience (1989 through 1991) of a specialized gastrointestinal (GI) bleeding team in the endoscopic treatment of acute upper GI bleeding from gastroduodenal malignant tumors was re...
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| Veröffentlicht in: | Mayo Clinic proceedings 1994-08, Vol.69 (8), p.736-740 |
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| creator | LOFTUS, EDWARD V. ALEXANDER, GLENN L. AHLQUIST, DAVID A. BALM, RITA K. |
| description | To summarize the results of endoscopic therapy for acute hemorrhage from gastroduodenal malignant lesions.
The 3-year experience (1989 through 1991) of a specialized gastrointestinal (GI) bleeding team in the endoscopic treatment of acute upper GI bleeding from gastroduodenal malignant tumors was retrospectively reviewed.
Of 1,083 consecutive patients with acute major upper GI hemorrhage, 21 (1.9%) were found to have advanced tumors of the stomach and duodenum, 15 of whom received endoscopic therapy. In this study group of 15 patients, the tumors were gastric in 11 and duodenal in 4. Endoscopic treatment consisted of injection of epinephrine, heater probe coagulation, neodymium:yttrium-aluminum-garnet laser coagulation, or injection of sodium tetradecyl sulfate.
Initial endoscopic hemostasis was achieved in 10 of the 15 patients (67%); however, bleeding recurred in 8 of 10 (80%), and all 5 in whom endoscopic hemostasis was not achieved continued to bleed. Mean transfusion requirements for the 30 days before and the 30 days after the first endoscopic treatment were 7.6 and 6.4 units of packed erythrocytes, respectively (P>0.10). Five major procedure-related complications occurred, two of which were fatal. The median duration of survival after the first endoscopic treatment was 39 days (range, 1 to 1,414).
In patients with major bleeding from advanced gastroduodenal malignant lesions, endoscopic therapy seems to provide limited benefit. |
| doi_str_mv | 10.1016/S0025-6196(12)61090-8 |
| format | Article |
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The 3-year experience (1989 through 1991) of a specialized gastrointestinal (GI) bleeding team in the endoscopic treatment of acute upper GI bleeding from gastroduodenal malignant tumors was retrospectively reviewed.
Of 1,083 consecutive patients with acute major upper GI hemorrhage, 21 (1.9%) were found to have advanced tumors of the stomach and duodenum, 15 of whom received endoscopic therapy. In this study group of 15 patients, the tumors were gastric in 11 and duodenal in 4. Endoscopic treatment consisted of injection of epinephrine, heater probe coagulation, neodymium:yttrium-aluminum-garnet laser coagulation, or injection of sodium tetradecyl sulfate.
Initial endoscopic hemostasis was achieved in 10 of the 15 patients (67%); however, bleeding recurred in 8 of 10 (80%), and all 5 in whom endoscopic hemostasis was not achieved continued to bleed. Mean transfusion requirements for the 30 days before and the 30 days after the first endoscopic treatment were 7.6 and 6.4 units of packed erythrocytes, respectively (P>0.10). Five major procedure-related complications occurred, two of which were fatal. The median duration of survival after the first endoscopic treatment was 39 days (range, 1 to 1,414).
In patients with major bleeding from advanced gastroduodenal malignant lesions, endoscopic therapy seems to provide limited benefit.</description><identifier>ISSN: 0025-6196</identifier><identifier>EISSN: 1942-5546</identifier><identifier>DOI: 10.1016/S0025-6196(12)61090-8</identifier><identifier>PMID: 8035627</identifier><identifier>CODEN: MACPAJ</identifier><language>eng</language><publisher>Rochester, MN: Elsevier Inc</publisher><subject>Acute Disease ; Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Digestive system. Abdomen ; Duodenal Neoplasms - complications ; Duodenal Neoplasms - pathology ; Duodenoscopy - adverse effects ; Endoscopy ; Female ; Gastrointestinal Hemorrhage - etiology ; Gastrointestinal Hemorrhage - therapy ; Gastroscopy - adverse effects ; Hemostatic Techniques - adverse effects ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Male ; Medical sciences ; Middle Aged ; Retrospective Studies ; Stomach Neoplasms - complications ; Stomach Neoplasms - pathology ; Survival Analysis ; Treatment Outcome</subject><ispartof>Mayo Clinic proceedings, 1994-08, Vol.69 (8), p.736-740</ispartof><rights>1994 Mayo Foundation for Medical Education and Research</rights><rights>1994 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c389t-e6acb32decaeb12ac7a0f6ed34e092dfb119d08425ce1caa1e5cb8908056c48b3</citedby><cites>FETCH-LOGICAL-c389t-e6acb32decaeb12ac7a0f6ed34e092dfb119d08425ce1caa1e5cb8908056c48b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=4214906$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8035627$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>LOFTUS, EDWARD V.</creatorcontrib><creatorcontrib>ALEXANDER, GLENN L.</creatorcontrib><creatorcontrib>AHLQUIST, DAVID A.</creatorcontrib><creatorcontrib>BALM, RITA K.</creatorcontrib><title>Endoscopic Treatment of Major Bleeding From Advanced Gastroduodenal Malignant Lesions</title><title>Mayo Clinic proceedings</title><addtitle>Mayo Clin Proc</addtitle><description>To summarize the results of endoscopic therapy for acute hemorrhage from gastroduodenal malignant lesions.
The 3-year experience (1989 through 1991) of a specialized gastrointestinal (GI) bleeding team in the endoscopic treatment of acute upper GI bleeding from gastroduodenal malignant tumors was retrospectively reviewed.
Of 1,083 consecutive patients with acute major upper GI hemorrhage, 21 (1.9%) were found to have advanced tumors of the stomach and duodenum, 15 of whom received endoscopic therapy. In this study group of 15 patients, the tumors were gastric in 11 and duodenal in 4. Endoscopic treatment consisted of injection of epinephrine, heater probe coagulation, neodymium:yttrium-aluminum-garnet laser coagulation, or injection of sodium tetradecyl sulfate.
Initial endoscopic hemostasis was achieved in 10 of the 15 patients (67%); however, bleeding recurred in 8 of 10 (80%), and all 5 in whom endoscopic hemostasis was not achieved continued to bleed. Mean transfusion requirements for the 30 days before and the 30 days after the first endoscopic treatment were 7.6 and 6.4 units of packed erythrocytes, respectively (P>0.10). Five major procedure-related complications occurred, two of which were fatal. The median duration of survival after the first endoscopic treatment was 39 days (range, 1 to 1,414).
In patients with major bleeding from advanced gastroduodenal malignant lesions, endoscopic therapy seems to provide limited benefit.</description><subject>Acute Disease</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Digestive system. Abdomen</subject><subject>Duodenal Neoplasms - complications</subject><subject>Duodenal Neoplasms - pathology</subject><subject>Duodenoscopy - adverse effects</subject><subject>Endoscopy</subject><subject>Female</subject><subject>Gastrointestinal Hemorrhage - etiology</subject><subject>Gastrointestinal Hemorrhage - therapy</subject><subject>Gastroscopy - adverse effects</subject><subject>Hemostatic Techniques - adverse effects</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Retrospective Studies</subject><subject>Stomach Neoplasms - complications</subject><subject>Stomach Neoplasms - pathology</subject><subject>Survival Analysis</subject><subject>Treatment Outcome</subject><issn>0025-6196</issn><issn>1942-5546</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1994</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkE1LxDAQhoMoun78BKEHET1UJ2mTbU6i4heseFDPYZpMJdI2a9IV_Pd23WWvnubwPu_M8DB2zOGCA1eXrwBC5oprdcbFueKgIa-22ITrUuRSlmqbTTbIHttP6RMAplqXu2y3gkIqMZ2w97vehWTD3NvsLRIOHfVDFprsGT9DzG5aIuf7j-w-hi67dt_YW3LZA6YhBrcIjnpsR7b1Hz2OxRklH_p0yHYabBMdrecBe7-_e7t9zGcvD0-317PcFpUeclJo60I4skg1F2inCI0iV5QEWrim5lw7qEohLXGLyEnautJQgVS2rOrigJ2u9s5j-FpQGkznk6W2xZ7CIpmpkhq4UCMoV6CNIaVIjZlH32H8MRzMUqf502mWrgwX5k-nqcbe8frAou7IbVprf2N-ss4xWWybOPrxaYOVgpcaluevVhiNMr49RZOsp6VKH8kOxgX_zyO_RfWSZA</recordid><startdate>19940801</startdate><enddate>19940801</enddate><creator>LOFTUS, EDWARD V.</creator><creator>ALEXANDER, GLENN L.</creator><creator>AHLQUIST, DAVID A.</creator><creator>BALM, RITA K.</creator><general>Elsevier Inc</general><general>Mayo Medical Ventures</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19940801</creationdate><title>Endoscopic Treatment of Major Bleeding From Advanced Gastroduodenal Malignant Lesions</title><author>LOFTUS, EDWARD V. ; ALEXANDER, GLENN L. ; AHLQUIST, DAVID A. ; BALM, RITA K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c389t-e6acb32decaeb12ac7a0f6ed34e092dfb119d08425ce1caa1e5cb8908056c48b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1994</creationdate><topic>Acute Disease</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Digestive system. Abdomen</topic><topic>Duodenal Neoplasms - complications</topic><topic>Duodenal Neoplasms - pathology</topic><topic>Duodenoscopy - adverse effects</topic><topic>Endoscopy</topic><topic>Female</topic><topic>Gastrointestinal Hemorrhage - etiology</topic><topic>Gastrointestinal Hemorrhage - therapy</topic><topic>Gastroscopy - adverse effects</topic><topic>Hemostatic Techniques - adverse effects</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Retrospective Studies</topic><topic>Stomach Neoplasms - complications</topic><topic>Stomach Neoplasms - pathology</topic><topic>Survival Analysis</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>LOFTUS, EDWARD V.</creatorcontrib><creatorcontrib>ALEXANDER, GLENN L.</creatorcontrib><creatorcontrib>AHLQUIST, DAVID A.</creatorcontrib><creatorcontrib>BALM, RITA K.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Mayo Clinic proceedings</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>LOFTUS, EDWARD V.</au><au>ALEXANDER, GLENN L.</au><au>AHLQUIST, DAVID A.</au><au>BALM, RITA K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Endoscopic Treatment of Major Bleeding From Advanced Gastroduodenal Malignant Lesions</atitle><jtitle>Mayo Clinic proceedings</jtitle><addtitle>Mayo Clin Proc</addtitle><date>1994-08-01</date><risdate>1994</risdate><volume>69</volume><issue>8</issue><spage>736</spage><epage>740</epage><pages>736-740</pages><issn>0025-6196</issn><eissn>1942-5546</eissn><coden>MACPAJ</coden><abstract>To summarize the results of endoscopic therapy for acute hemorrhage from gastroduodenal malignant lesions.
The 3-year experience (1989 through 1991) of a specialized gastrointestinal (GI) bleeding team in the endoscopic treatment of acute upper GI bleeding from gastroduodenal malignant tumors was retrospectively reviewed.
Of 1,083 consecutive patients with acute major upper GI hemorrhage, 21 (1.9%) were found to have advanced tumors of the stomach and duodenum, 15 of whom received endoscopic therapy. In this study group of 15 patients, the tumors were gastric in 11 and duodenal in 4. Endoscopic treatment consisted of injection of epinephrine, heater probe coagulation, neodymium:yttrium-aluminum-garnet laser coagulation, or injection of sodium tetradecyl sulfate.
Initial endoscopic hemostasis was achieved in 10 of the 15 patients (67%); however, bleeding recurred in 8 of 10 (80%), and all 5 in whom endoscopic hemostasis was not achieved continued to bleed. Mean transfusion requirements for the 30 days before and the 30 days after the first endoscopic treatment were 7.6 and 6.4 units of packed erythrocytes, respectively (P>0.10). Five major procedure-related complications occurred, two of which were fatal. The median duration of survival after the first endoscopic treatment was 39 days (range, 1 to 1,414).
In patients with major bleeding from advanced gastroduodenal malignant lesions, endoscopic therapy seems to provide limited benefit.</abstract><cop>Rochester, MN</cop><pub>Elsevier Inc</pub><pmid>8035627</pmid><doi>10.1016/S0025-6196(12)61090-8</doi><tpages>5</tpages></addata></record> |
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| subjects | Acute Disease Adult Aged Aged, 80 and over Biological and medical sciences Digestive system. Abdomen Duodenal Neoplasms - complications Duodenal Neoplasms - pathology Duodenoscopy - adverse effects Endoscopy Female Gastrointestinal Hemorrhage - etiology Gastrointestinal Hemorrhage - therapy Gastroscopy - adverse effects Hemostatic Techniques - adverse effects Humans Investigative techniques, diagnostic techniques (general aspects) Male Medical sciences Middle Aged Retrospective Studies Stomach Neoplasms - complications Stomach Neoplasms - pathology Survival Analysis Treatment Outcome |
| title | Endoscopic Treatment of Major Bleeding From Advanced Gastroduodenal Malignant Lesions |
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