Hemostat in comparison with metallic hemoclip for hemostasis and preventing post-procedure bleed- ing after endoscopic mucosal resection： a prospective, randomized trial

Objective To compare the clinical effects of hemostat and metallic hemoclip on bleed- ing control and prevention after endoscopic mucosal resection. Methods A total of 164 patients, who re- ceived colorectal EMR in our hospital from April 2009 to July 2011, were randomly divided into hemostat group or hemoclip group, 82 cases in each. The hemostatic time, hemostatic rates, rebleeding rates and treatment-related complications were compared. Results The hemostatic times of hemostat group and hemo- clip group were 64 （ 37-114 ） s and 123 （ 82-234 ） s, respectively （ P 〈 0. O1 ）. Twenty lesions in hemostat group and 19 lesions in hemoclip group showed bleeding immediately after procedure, with hemostatic rates of 90. 0% （18/20） and 89.5% （17/19） , respectively （ P = 0. 677）. Lesions of unsuccessful hemostatis in each group were treated by hot biopsy forceps or argon plasma coagulation, and complete hemostasis was achieved in all cases without referring to surgery. The rebleeding rates within 72 hours in hemostat group and hemoclip group were 25. 0% （5/20） and 15.8% （3/19） （P =0. 695）. In patients without bleeding immedi-ately after procedure, the procedures were performed for prophylaxis, the bleeding rates of whom were 4. 8% （3/62） in hemostat group and 9.5% （6/63）in hemoclip group （P = 0. 491 ） within 72 hours. No major ad- verse events of treatment were reported during 30-day follow-up. Colonoscopy was performed at the 30th day of the follow-up and complete healing of mueosal defect was observed in all cases. Conehtsion Hemostat showed efficacy on post-EMR hemostatsis and bleeding prevention with the advantage of less procedure time, thus might be a useful alternative to control bleeding endoscopically. Key words: Hemostat ;  Polysaccharide hemostatic system （ EndoClot ） ;  Metallic hemoclip ;  Endoscopic mucosal resection