Skip to main content

Advertisement

SpringerLink
Log in

Efficacy of cyanoacrylate in the prevention of delayed bleeding after endoscopic mucosal resection of large colorectal polyps: a pilot study

  • Short Communication
  • Published:
International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Background

Postoperative bleeding is a common complication after endoscopic polypectomy, particularly after endoscopic mucosal resection (EMR) of large non-pedunculated polyps, despite prophylactic clipping can reduce its occurrence. Cyanoacrylate glue has recently been proposed as a useful tool in reducing bleeding in surgery because of its adhesive and haemostatic properties.

The aim of this study is to evaluate the usefulness of endoscopic application of a modified cyanoacrylate glue in the prevention of early or delayed post EMR bleeding.

Methods

This is a pilot study. Inclusion criteria were patients between 18 and 75 years old affected by sessile or flat colonic polyps larger than 2 cm. Patients enrolled in the study were randomized in two groups: group A (EMR) and group B (EMR with the application of 0.3 ml of N-butyl-2-cyanoacrylate + methacryloxysulfolane—Glubran 2®).

Results

Fifteen patients in both group A and B were enrolled. There were no intraoperative complications but haemostatic clipping was necessary in 3 patients in each group because of active bleeding. Delayed (after 24 h) bleeding occurred in two patients (13.3%) in group A requiring hospital readmission and re-do endoscopy with apposition of haemostatic clips. No case of bleeding was recorded in group B (p = 0.48).

Conclusion

The results of this pilot study suggest a potential role of local spray application of Glubran®2 in reducing post-procedural bleeding.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

References

  1. Zauber AG, Winawer SJ, O'Brien MJ, Lansdorp-Vogelaar I, van Ballegooijen M, Hankey BF, Shi W, Bond JH, Schapiro M, Panish JF, Stewart ET, Waye JD (2012) Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths. N Engl J Med 366(8):687–696

    Article  CAS  Google Scholar 

  2. Bronsgeest K, Huisman JF, Langers A, Boonstra JJ, Schenk BE, de Vos tot Nederveen Cappel WH, Vasen HFA, Hardwick JCH (2017) Safety of endoscopic mucosal resection (EMR) of large non-pedunculated colorectal adenomas in the elderly. Int J Color Dis 32(12):1711–1717

    Article  CAS  Google Scholar 

  3. Seidel J, Färber E, Baumbach R, Cordruwisch W, Böhmler U, Feyerabend B, Faiss S (2016) Complication and local recurrence rate after endoscopic resection of large high-risk colorectal adenomas of >/=3 cm in size. Int J Color Dis 31(3):603–611

    Article  CAS  Google Scholar 

  4. Jameel JK et al (2006) Endoscopic mucosal resection (EMR) in the management of large colo-rectal polyps. Color Dis 8(6):497–500

    Article  CAS  Google Scholar 

  5. Ayoub F, Westerveld DR, Forde JJ, Forsmark CE, Draganov PV, Yang D (2019) Effect of prophylactic clip placement following endoscopic mucosal resection of large colorectal lesions on delayed polypectomy bleeding: a meta-analysis. World J Gastroenterol 25(18):2251–2263

    Article  Google Scholar 

  6. Changela K, Papafragkakis H, Ofori E, Ona MA, Krishnaiah M, Duddempudi S, Anand S (2015) Hemostatic powder spray: a new method for managing gastrointestinal bleeding. Ther Adv Gastroenterol 8(3):125–135

    Article  CAS  Google Scholar 

  7. Weilert F, Binmoeller KF (2016) Cyanoacrylate glue for gastrointestinal bleeding. Curr Opin Gastroenterol 32(5):358–364

    Article  CAS  Google Scholar 

  8. Sethi A, Song LM (2015) Adverse events related to colonic endoscopic mucosal resection and polypectomy. Gastrointest Endosc Clin N Am 25(1):55–69

    Article  Google Scholar 

  9. Parra-Blanco A, Kaminaga N, Kojima T, Endo Y, Uragami N, Okawa N, Hattori T, Takahashi H, Fujita R (2000) Hemoclipping for postpolypectomy and postbiopsy colonic bleeding. Gastrointest Endosc 51(1):37–41

    Article  CAS  Google Scholar 

  10. Van Gossum A et al (1992) Colonoscopic snare polypectomy: analysis of 1485 resections comparing two types of current. Gastrointest Endosc 38(4):472–475

    Article  Google Scholar 

  11. Kim JH, Lee HJ, Ahn JW, Cheung DY, Kim JI, Park SH, Kim JK (2013) Risk factors for delayed post-polypectomy hemorrhage: a case-control study. J Gastroenterol Hepatol 28(4):645–649

    Article  Google Scholar 

  12. Kull S, Martinelli I, Briganti E, Losi P, Spiller D, Tonlorenzi S, Soldani G (2009) Glubran2 surgical glue: in vitro evaluation of adhesive and mechanical properties. J Surg Res 157(1):e15–e21

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Emergency and Organ transplantation, Surgical Unit “M.Rubino”, Azienda Ospedaliero Universitaria Policlinico, Bari, Italy

    Gennaro Martines, Arcangelo Picciariello, Rigers Dibra, Giuseppe Trigiante, O. Caputi Jambrenghi, Nicola Chetta & Donato Francesco Altomare

  2. IRCCS Istituto Tumori Giovanni Paolo II, Bari, Italy

    Donato Francesco Altomare

  3. Department of Emergency and Organ Transplantation, University “Aldo Moro” of Bari, Piazza G Cesare, 11, 70124, Bari, Italy

    Donato Francesco Altomare

Authors
  1. Gennaro Martines
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Arcangelo Picciariello
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Rigers Dibra
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Giuseppe Trigiante
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. O. Caputi Jambrenghi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Nicola Chetta
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Donato Francesco Altomare
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Donato Francesco Altomare.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Martines, G., Picciariello, A., Dibra, R. et al. Efficacy of cyanoacrylate in the prevention of delayed bleeding after endoscopic mucosal resection of large colorectal polyps: a pilot study. Int J Colorectal Dis 35, 2141–2144 (2020). https://doi.org/10.1007/s00384-020-03678-9

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00384-020-03678-9

Keywords

Search

Navigation