{
  "abstract": "Objective PuraStat is a topical haemostatic agent used for treatment and prevention of bleeding. Our aim was to evaluate the efficacy and safety of using PuraStat during advanced endoscopic resection procedures in a multicentre prospective setting.Design/methods This is a multicentre prospective evaluation on efficacy and safety of PuraStat when used in the treatment of intraprocedural bleeding and prevention of delayed bleeding during the study period from 2019 to 2021. High-risk tissue resections (HRTR) with endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) for large and complex lesions from the oesophagus, stomach, duodenum and colon were included. Data on the type of bleed, haemostatic measures used, and efficacy and safety of PuraStat were prospectively collected. A descriptive analysis was performed and expressed as proportions.Results PuraStat was used in a total of 448 patients with HRTR. PuraStat was used for treatment of intraprocedural bleeding in 105 patients. Overall haemostatic efficacy in this group was 91.43%. All 448 patients had prophylactic application of PuraStat on the resection base to prevent delayed bleeding. The observed overall delayed bleeding rate for the entire cohort was 1.34%. On subgroup analysis, we found that this was highest in the duodenum (8.69%) followed by 1.80% in the right colon (EMR and ESD). There were no delayed bleeds in the oesophagus, stomach and left colon.Conclusions Our data demonstrates that PuraStat is safe and appears to be effective in the treatment of intraprocedural bleeding and prevention of delayed bleeding after high-risk endoscopic resections.Trial registration number NCT03983707.",
  "authors": [
    {
      "affiliations": [
        "Portsmouth Hospitals University NHS Trust, Portsmouth, UK",
        "School of Medicine, Pharmacy and Biomedical Sciences, Faculty of Science and Health, University of Portsmouth, Portsmouth, UK"
      ],
      "name": "Hein Myat Thu Htet"
    },
    {
      "affiliations": [
        "Gastroenterology, Portsmouth Hospitals University NHS Trust, Portsmouth, UK"
      ],
      "name": "Sharmila Subramaniam"
    },
    {
      "affiliations": [
        "Gastroenterology, Nottingham University Hospitals NHS Trust, Nottingham, UK"
      ],
      "name": "Adolfo Parra-Blanco"
    },
    {
      "affiliations": [
        "St Mark’s Hospital and Academic Institute, London, UK"
      ],
      "name": "Brian Saunders"
    },
    {
      "affiliations": [
        "St Mark’s Hospital and Academic Institute, London, UK"
      ],
      "name": "Noriko Suzuki"
    },
    {
      "affiliations": [
        "Colorectal Surgery, King’s College Hospital NHS Foundation Trust, London, UK"
      ],
      "name": "Amyn Haji"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, King’s College Hospital NHS Foundation Trust, London, UK"
      ],
      "name": "Bu’Hussain Hayee"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, Salford Royal NHS Foundation Trust, Salford, UK"
      ],
      "name": "Yeng Ang"
    },
    {
      "affiliations": [
        "Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK"
      ],
      "name": "Massimiliano di Pietro"
    },
    {
      "affiliations": [
        "University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"
      ],
      "name": "Marietta Iacucci"
    },
    {
      "affiliations": [
        "University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"
      ],
      "name": "Marcus Mottershead"
    },
    {
      "affiliations": [
        "Gastroenterology, North Tees and Hartlepool NHS Foundation Trust, Stockton-on-Tees, UK"
      ],
      "name": "Iosif Beintaris"
    },
    {
      "affiliations": [
        "Portsmouth Hospitals University NHS Trust, Portsmouth, UK",
        "School of Medicine, Pharmacy and Biomedical Sciences, Faculty of Science and Health, University of Portsmouth, Portsmouth, UK"
      ],
      "name": "Katie Siggens"
    },
    {
      "affiliations": [
        "Portsmouth Hospitals University NHS Trust, Portsmouth, UK"
      ],
      "name": "Elisabetta Mastrorocco"
    },
    {
      "affiliations": [
        "Portsmouth Hospitals University NHS Trust, Portsmouth, UK"
      ],
      "name": "Mohamed Abdelrahim"
    },
    {
      "affiliations": [
        "Portsmouth Hospitals University NHS Trust, Portsmouth, UK"
      ],
      "name": "Ejaz Hossain"
    },
    {
      "affiliations": [
        "Gastroenterology, Portsmouth Hospitals University NHS Trust, Portsmouth, UK"
      ],
      "name": "Gaius Longcroft-Wheaton"
    },
    {
      "affiliations": [
        "Portsmouth Hospitals University NHS Trust, Portsmouth, UK"
      ],
      "name": "Fergus Thursby-Pelham"
    },
    {
      "affiliations": [
        "Portsmouth Hospitals University NHS Trust, Portsmouth, UK"
      ],
      "name": "Sophie Arndtz"
    },
    {
      "affiliations": [
        "Guy's and St Thomas’ NHS Foundation Trust, London, UK"
      ],
      "name": "Sebastian Zeki"
    },
    {
      "affiliations": [
        "Gastroenterology, Guy's and St Thomas’ NHS Foundation Trust, London, UK"
      ],
      "name": "Jason Dunn"
    },
    {
      "affiliations": [
        "Gastroenterology, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, UK"
      ],
      "name": "John Anderson"
    },
    {
      "affiliations": [
        "Portsmouth Hospitals University NHS Trust, Portsmouth, UK",
        "School of Medicine, Pharmacy and Biomedical Sciences, Faculty of Science and Health, University of Portsmouth, Portsmouth, UK"
      ],
      "name": "Pradeep Bhandari"
    }
  ],
  "title": "Effectiveness and safety of a haemostatic gel in the treatment of intraprocedural bleeding and prevention of delayed bleeding after advanced endoscopic resection of large and complex gastrointestinal neoplasia: a multicentre prospective observational PuraStat study",
  "uid": "9a4c3ae3-0104-5cb6-a981-22ff95556b77"
}