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CC BY-NC-ND 4.0 · Endosc Int Open 2021; 09(08): E1283-E1290
DOI: 10.1055/a-1495-4764
Original article

Effectiveness of hemostatic powders in lower gastrointestinal bleeding: a systematic review and meta-analysis

Antonio Facciorusso
1   Gastroenterology Unit, Department of Medical and Surgical Sciences, University of Foggia, Italy
,
Marco Bertini
2   Gastrointestinal Endoscopy Unit, Department of Surgery, Pisa University Hospital, Pisa, Italy
,
Michele Bertoni
2   Gastrointestinal Endoscopy Unit, Department of Surgery, Pisa University Hospital, Pisa, Italy
,
Nicola Tartaglia
3   General Surgery Unit, Department of Medical and Surgical Sciences, University of Foggia, Italy
,
Mario Pacilli
3   General Surgery Unit, Department of Medical and Surgical Sciences, University of Foggia, Italy
,
Daryl Ramai
4   Gastroenterology and Hepatology, Brooklyn Hospital Medical Center, Brooklyn, New York, United States
,
Babu P. Mohan
5   Gastroenterology and Hepatology, University of Utah Health, Salt Lake City, Utah, United States
,
Saurabh Chandan
6   Gastroenterology Unit, CHI Health Creighton University Medical Center, Omaha, Nebraska, United States
,
Antonio Ambrosi
3   General Surgery Unit, Department of Medical and Surgical Sciences, University of Foggia, Italy
,
Rodolfo Sacco
1   Gastroenterology Unit, Department of Medical and Surgical Sciences, University of Foggia, Italy
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Abstract

Background and study aims There is limited evidence on the effectiveness of hemostatic powders in the management of lower gastrointestinal bleeding (LGIB). We aimed to provide a pooled estimate of their effectiveness and safety based on the current literature.

Patients and methods Literature review was based on computerized bibliographic search of the main databases through to December 2020. Immediate hemostasis, rebleeding rate, adverse events, and mortality were the outcomes of the analysis. Pooled effects were calculated using a random-effects model.

Results A total of 9 studies with 194 patients were included in the meta-analysis. Immediate hemostasis was achieved in 95 % of patients (95 % confidence interval [CI] 91.6 %–98.5 %), with no difference based on treatment strategy or bleeding etiology. Pooled 7- and 30-day rebleeding rates were 10.9 % (95 %CI 4.2 %–17.6 %) and 14.3 % (95 %CI 7.3 %–21.2 %), respectively. Need for embolization and surgery were 1.7 % (95 %CI 0 %–3.5 %) and 2.4 % (95 %CI 0.3 %–4.6 %), respectively. Overall, two patients (1.9 %, 95 %CI 0 %–3.8 %) experienced mild abdominal pain after powder application, and three bleeding-related deaths (2.3 %, 95 %CI 0.2 %–4.3 %) were registered in the included studies.

Conclusion Novel hemostatic powders represent a user-friendly and effective tool in the management of lower gastrointestinal bleeding.

Supplementary material



Publication History

Received: 03 February 2021

Accepted: 14 April 2021

Article published online:
16 July 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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