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DOI: 10.1055/a-1781-7066
Safety and efficacy of dual emission endoscopic laser treatment in patients with upper or lower gastrointestinal vascular lesions causing chronic anemia: results from the first multicenter cohort study
Abstract
Objectives and study aims Recent pilot studies have assessed the feasibility of a novel 1.9-/1.5-μm dual emission endoscopic laser treatment (1.9-/1.5-μmDEELT) for endoscopic hemostasis, ablation and resection. In this study, we investigated the safety and efficacy of 1.9-/1.5-μmDEELT in patients with chronic anemia due to gastrointestinal vascular lesions in a real-life multicenter cohort setting.
Patients and methods Consecutive patients with moderate/severe iron-deficiency anemia undergoing 1.9-/1.5-μmDEELT for upper and lower gastrointestinal bleeding due to vascular lesions were enrolled in three academic referral centers. Safety and successful ablation of vascular lesions were the primary outcomes. Long-term hemoglobin level, blood transfusion requirements, endoscopic severity scores of complex vascular disorders and technical lasing parameters were also assessed. Long-term hemoglobin variations have been further assessed, with repeated measure analysis of variance and univariate analyses.
Results Fifty patients (median age 74; range 47 to 91 years) with gastric antral vascular ectasia (GAVE) (22), angioectasia (22) and radiation proctopathy (6) underwent 58 1.9-/1.5-μmDEELT between 2016 and 2020. All procedures were technically feasible leading to successful ablation of the targeted lesion/s, with no incident or adverse event potentially related to the 1.9-/1.5-μmDEELT technique. Within a 6-month follow-up, hemoglobin values significantly rose (+ 1.77 at 1 month and + 1.70 g/dL at 6 months, P < 0.01), the blood supply requirement decreased (at least one transfusion in 32 versus 13 patients, P < 0.01), and GAVE lesions showed a clear endoscopic improvement (from 5 points to 1 points, P < 0.01).
Conclusions The 1.9-/1.5-μm laser system is a safe and effective endoscopic tool for haemostatic ablation of bleeding vascular lesions within the gastrointestinal tract in tertiary referral centers.
Publikationsverlauf
Eingereicht: 28. August 2021
Angenommen: 21. September 2021
Artikel online veröffentlicht:
14. April 2022
© 2022. 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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