Preventive X-ray endovascular arterial embolization in patients with ulcerative gastroduodenal bleeding with a high risk of recurrence
https://doi.org/10.17238/2072-3180-2023-1-50-56
Abstract
Introduction. Peptic ulcer is the main cause of bleeding from the upper gastrointestinal tract (GT). Ulcerative bleeding (UB) remains one of the leading diseases in the structure of emergency medical care. The total mortality in this pathology reaches 40% taking into account laparotomies. This the need for further search for optimal treatment methods. One of which is Preventive transcatheter arterial embolization(TAE) in patients with a high risk of recurrent bleeding.
Study purpose. To evaluate the effectiveness of TAE in patients with a high risk of recurrent gastrointestinal bleeding (RGIB).
Materials and methods. The study included 84 patients with UBa high risk of RGIB. The main group consisted of 40 patients who underwent preventive TAE, the control group consisted of 44 patients who underwent TAE after 2 relapses. The number of relapses, laparotomies and mortality rates were compared.
Outcomes. When compared in the main group, there was a decrease in the average stay in hospitalof 6,1 versus 8,3 (p=0,017), the relapse rate of 7,5% versus 27,3% (p=0,002), mortality rates of 1 patient versus 8 (p=0,002), there was no need for laparotomy (p=0,028).
Conclusion. The problem of recurrence of ulcerative bleeding, with subsequent complications up to death, dictates the need for correct and timely stratification of the high risk of recurrent bleeding and determining optimal treatment tactics, leading to a decrease in the number of relapses, laparotomies, mortality. Preventive TAE according to the results of the analysis fully satisfies these requirements.
About the Authors
V. V. Bedin
Botkin Hospital; Department of Surgery, Russian Medical Academy of Postgraduate Professional Education, Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Bedin Vladimir Vladimirovich – Doctor of medical Sciences, Professor; Deputy chief physician (surgical department)
125284, Moscow, 2-nd Botkinsky pr., 5
I. Yu. Korzheva
Botkin Hospital; Department of Surgery, Russian Medical Academy of Postgraduate Professional Education, Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Korzheva Irina Yur’evna – Doctor of medical Sciences. Head; Head of endoscopy department
125284, Moscow, 2-nd Botkinsky pr., 5
V. A. Tsurkan
Botkin Hospital
Russian Federation
Russian Federation
Tsurkan Vladimir Andreevich – radiologist of the Department of radiosurgical methods of diagnosis and treatment
125284, Moscow, 2-nd Botkinsky pr., 5
D. S. Bocharnikov
Botkin Hospital
Russian Federation
Russian Federation
Bocharnikov Dmitrii Stepanovich – Head of the Department of Emergency Surgical Care № 75
125284, Moscow, 2-nd Botkinsky pr., 5
K. A. Sokolov
Botkin Hospital
Russian Federation
Russian Federation
Sokolov Kirill Anatolevich – surgeon of the Department of emergency surgical care № 75
125284, Moscow, 2-nd Botkinsky pr., 5
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Review
For citations:
Bedin V.V., Korzheva I.Yu., Tsurkan V.A., Bocharnikov D.S., Sokolov K.A. Preventive X-ray endovascular arterial embolization in patients with ulcerative gastroduodenal bleeding with a high risk of recurrence. Moscow Surgical Journal. 2023;(1):50-56. (In Russ.) https://doi.org/10.17238/2072-3180-2023-1-50-56
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