» Articles » PMID: 2196207

Heat Probe Thermocoagulation and Pure Alcohol Injection in Massive Peptic Ulcer Haemorrhage: a Prospective, Randomised Controlled Trial

Overview
Journal Gut
Specialty Gastroenterology
Date 1990 Jul 1
PMID 2196207
Citations 18
Authors
Affiliations
Soon will be listed here.
Abstract

We conducted a prospective randomised controlled trial of 137 patients with massive peptic ulcer haemorrhage over a period of 12 months to compare the haemostatic effects of endoscopic heat probe thermocoagulation and pure alcohol injection. Seventy eight patients (56.9%) were in shock at the time of randomisation to the trial. The age, sex, number of patients in shock, haemoglobin value at the time of entry to the trial, number of patients with severe medical illness, location of bleeders, and stigmata of recent haemorrhage were comparable among the heat probe, pure alcohol, and control groups. The initial haemostatic effect of the heat probe was better than that of the pure alcohol injection (44 of 45 v 31 of 46, p = 0.0004). The ultimate haemostasis achieved by the heat probe group (41 of 45) was better than that of the pure alcohol group (31 of 46, p = 0.012) and of controls (24 of 46, p = 0.0001). The duration of hospital stay was shorter for patients in the heat probe group than for the control group (6.2 days v 13.8 days, p less than 0.05). The incidence of emergency surgery was less for the heat probe than the control group (three of 45 v 12 of 46, p = 0.027). The mortality rate was less in the heat probe than in the control group (one of 45 v seven of 46, p = 0.031). We suggest that heat probe thermocoagulation should be the first treatment of choice for arrest of massive peptic ulcer haemorrhage.

Citing Articles

Turn over the new leaf of the treatment in peptic ulcer bleeding: a review of the literature.

Lu M, Chiang H Therap Adv Gastroenterol. 2024; 17:17562848241275318.

PMID: 39253108 PMC: 11382247. DOI: 10.1177/17562848241275318.


Endoscopic hemostasis for peptic ulcer bleeding: systematic review and meta-analyses of randomized controlled trials.

Baracat F, Moura E, Bernardo W, Pu L, Mendonca E, Moura D Surg Endosc. 2015; 30(6):2155-68.

PMID: 26487199 DOI: 10.1007/s00464-015-4542-x.


A randomised controlled comparison of injection, thermal, and mechanical endoscopic methods of haemostasis on mesenteric vessels.

Hepworth C, Kadirkamanathan S, Gong F, Swain C Gut. 1998; 42(4):462-9.

PMID: 9616305 PMC: 1727069. DOI: 10.1136/gut.42.4.462.


Endoscopic injection therapy to prevent rebleeding from peptic ulcers with a protruding vessel: a controlled comparative trial.

Rutgeerts P, Gevers A, Hiele M, BROECKAERT L, VANTRAPPEN G Gut. 1993; 34(3):348-50.

PMID: 8472981 PMC: 1374139. DOI: 10.1136/gut.34.3.348.


Is sclerosant injection mandatory after an epinephrine injection for arrest of peptic ulcer haemorrhage? A prospective, randomised, comparative study.

Lin H, Perng C, Lee S Gut. 1993; 34(9):1182-5.

PMID: 8406150 PMC: 1375450. DOI: 10.1136/gut.34.9.1182.


References
1.
SCHILLER K, TRUELOVE S, Williams D . Haematemesis and melaena, with special reference to factors influencing the outcome. Br Med J. 1970; 2(5700):7-14. PMC: 1699731. DOI: 10.1136/bmj.2.5700.7. View

2.
Johnston J . Endoscopic hemostasis for bleeding peptic ulcer. Gastrointest Endosc. 1987; 33(3):260-2. DOI: 10.1016/s0016-5107(87)71577-6. View

3.
Allan R, Dykes P . A study of the factors influencing mortality rates from gastrointestinal haemorrhage. Q J Med. 1976; 45(180):533-50. View

4.
Protell R, RUBIN C, Auth D, Silverstein F, Terou F, Dennis M . The heater probe: a new endoscopic method for stopping massive gastrointestinal bleeding. Gastroenterology. 1978; 74(2 Pt 1):257-62. View

5.
Griffiths W, Neumann D, Welsh J . The visible vessel as an indicator of uncontrolled or recurrent gastrointestinal hemorrhage. N Engl J Med. 1979; 300(25):1411-3. DOI: 10.1056/NEJM197906213002503. View