Efficacy of polyglycolic acid sheets and fibrin glue for the prevention of post-ELPS bleeding. Issue 3 (June 2021)

• Record Type: Journal Article
• Authors: Sugimoto, Shinya; Fuke, Tomohito; Kobayashi, Daisuke; Ueda, Kohki; Sawa, Masahiro; Kaneko, Mamika; Fukukita, Kohei; Temma, Taishi; Nomura, Tatsuma; Fuwa, Nobukazu; Yamada, Hiroyuki
• Is Part Of: Auris nasus larynx. Volume 48:Issue 3(2021)
• Page Start: 471
• Page End: 476
• Publication Date: 2021-06
• Subjects: Postoperative bleeding -- Polyglycolic acid sheets -- Fibrin glue -- Endoscopic laryngopharyngeal surgery -- Endoscopic submucosal dissection; Otolaryngology -- Periodicals; Electronic journals; 616
• DOI: 10.1016/j.anl.2020.09.021
• Languages: English
• ISSNs: 0385-8146

Abstract

Abstract: Objective: To assess the efficacy and safety of a covering method using polyglycolic acid (PGA) sheets and fibrin glue in preventing laryngopharyngeal bleeding after endoscopic laryngopharyngeal surgery (ELPS) combined with endoscopic submucosal dissection (ESD). Methods: Twenty-one patients who underwent ELPS combined with ESD (28 resected pharyngeal carcinomas) were retrospectively evaluated. After completing ELPS combined with ESD, fibrinogen was sprayed onto the ulcer. A PGA sheet cut into 5 × 5 mm pieces that fit the size of the ELPS-induced ulcer was then placed over the ulcer and fixed in place with a fibrin glue comprising thrombin. Results: The resection procedure was performed for all lesions. The median long diameter of the resected specimen was 36 mm. The rate of a resected specimen diameter >30 mm, use of anticoagulant/platelet, and macroscopic classification 0-Ⅱa were 68% (19/28), 19% (5/28), and 36% (10/28), respectively. The median time required to cover ELPS-induced ulcers using PGA sheets and fibrin glue was 10 min (range: 3–22 min). No post-ELPS bleeding, subcutaneous emphysema, or aspiration pneumonia (0/28) was observed. Conclusion: The covering method using PGA sheets and fibrin glue for ELPS-induced ulcers is considered to be sufficiently safe and effective in preventing post-ELPS laryngopharyngeal bleeding. This method could be useful in preventing post-ELPS bleeding in patients with head and neck cancer.