Hemocoagulase vs. Epinephrine in Endoscopic Mucosal Resection:Prospective Randomized Controlled Study / 中国微创外科杂志

ABSTRACT

Objective To compare the anti-hemorrhage effect and safety of hemocoagulase and epinephrine (1∶10 000) during endoscopic mucosal resection (EMR) or polyps electrocautery. Methods Between April and November 2007,totally 60 patients received EMR or endoscopic piecemeal mucosal resection (EPMR) in our hospital because of local lesions in the esophagus,stomach or colon. The patients were randomly divided into hemocoagulase and epinephrine groups (30 cases in each) before receiving the operation. After the resection,the hemorrhage at the surgical area was measured. During the operation,the blood pressure,heart rate,and adverse effects including palpitation,dizziness,pain,and nausea were recorded. Results Immediate hemorrhage was detected in 1 case of hemocoagulase group (1/30,3%),and 6 cases of epinephrine group (6/30,20%,?2=2.588,P=0.108). No hemorrhage was observed at 24 hours in both the groups. No significantly difference was noticed in the injection volume between the two groups [(11.0?6.0) ml (5-30 ml) in hemocoagulase group vs. (11.9?7.0) ml (5-28 ml); t=-0.535,P=0.595]. In epinephrine group,the mean artery blood pressure and heart rate increased significantly after the injection [(96.9?7.9) mm Hg vs. (99.9?8.1) mm Hg,t=-3.005,P=0.005; 79.8?7.9/min vs. 84.3?8.1/min,t=-3.585,P=0.001]. Whereas,no such differences were noticed in hemocoagulase group. Five cases in epinephrine group showed transient dizziness and palpitation,and 2 patients who had esophageal lesions complained of pain at the injection site. None of the hemocoagulase group had postoperative complications. Conclusions Hemocoagulase shows same anti-hemorrhage effect as epinephrine during EMR without leading to adverse effect.