The Effects of Endoscopic Sodium Alginate Powder (Alto Shooter(TM)) in Peptic Ulcer Bleeding / 대한소화기내시경학회지

BACKGROUND/AIMS: Peptic ulcer bleeding can be treated by endoscopic laser, argon plasma coagulation, heater probe, or electrocoagulation. However, techinical difficulties and significant rebleeding rate after such endoscopic hemostasis, offer some beneficial effect of Alto Shooter(TM) as an adjuvant therapy in active peptic ulcer bleeding. METHODS: Twenty-three patients with active peptic ulcer bleeding were randomized to Alto Shooter(TM) & argon plasma coagulation therapy (ALTO+APC) or argon plasma coagulation therapy alone (APC). Forrest classifications were used to compare the effect of bleeding control. RESULTS: The Forrest classifications in two groups before treatment were Ib (6 patients), IIa (11 patients) in "ALTO+APC", Ib (2 patients) and IIa (4 patients) in "APC". The Forrest classifications of two groups at follow-up endoscopy were Ia (1 patient), Ib (1 patient), IIc (14 patients), III (1 patient) in "ALTO+APC" and IIc (6 patients) in "APC". There was no significant difference in hemostatic effect between "ALTO+APC" (p=0.001) and "APC" (p=0.001) groups. CONCLUSIONS: Alto Shooter(TM) offers no advantage over conventional endoscopic argon plasma coagulation therapy in controlling active peptic ulcer bleeding. Therefore routine addition of Alto ShooterTM treatment may not be recommended after initial successful endoscopic argon plasma coagulation therapy in active peptic ulcer bleeding.

Successful Treatment of Multiple Superficial Gastric Antral Bleeding with Alto Shooter(TM) in a Patient with End Stage Renal Disease / 대한소화기내시경학회지

Diffuse or multifocal superficial gastrointestinal bleeding can be treated by endoscopic laser, argon plasma coagulation, heater probe, or electrocoagulation. However, these methods need relatively expensive equipments and clinical experience. Recently, Alto Shooter(TM) (Kaigen Co. Ltd., Osaka, Japan) which can spray 100% sodium alginate was developed to control gastrointestinal bleeding as a topical therapy. We herein present a 47-year-old man with end stage renal disease in whom multiple superficial gastric antral bleeding was successfully managed by the use of Alto Shooter(TM). This method is easy and relatively cheap to use and seems to control superficial bleeding effectively from vascular lesions or after endoscopic biopsy.