Innovative utilization of argon plasma coagulation combined with endoclips for managing gastrointestinal bleeding attributed to colonic diverticular bleeding: a retrospective study

氩等离子体凝固术联合内镜夹治疗结肠憩室出血引起的胃肠道出血的创新应用:一项回顾性研究

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Abstract

BACKGROUND: Colonic diverticular bleeding is one of the primary causes of lower gastrointestinal bleeding, with endoscopic hemostasis as the first-line treatment. However, the outcomes of endoscopic treatments remain suboptimal. This study utilized an innovative therapeutic method to manage colonic diverticular bleeding and evaluated its feasibility and safety in clinical settings. METHODS: Between July 2018 and July 2023, 35 patients with colonic divercular bleeding were treated through argon plasma coagulation combined with endoclips (APC-EC) at the Air Force Medical Center. The technical success rate, rebleeding rate, and complications associated with the therapeutic method over a 5-year period were retrospectively analyzed. RESULTS: The technical success rate of the method was 100%, the early rebleeding rate of APC-EC was 8.57%. The incidence of late rebleeding at 1-year follow-up was 5.71%, it was 0% at the 2- and 3-year follow-up periods. Intraoperative perforation was observed only in two patients treated with APC-EC; however, delayed perforation was not observed in any patient, and none of them required surgical treatment. CONCLUSIONS: APC-EC might be a viable, safe, and effective method for treating colonic divercular bleeding.

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