The role of improved endoscopic purse-string suturing for high-risk peptic ulcer hemorrhage: A randomized controlled pilot study

ObjectivePeptic ulcer hemorrhage is associated with considerable morbidity and mortality. This study aimed to evaluate the role of improved endoscopic purse-string suturing for the treatment of peptic ulcer hemorrhage.MethodsThis prospective, randomized, controlled, single-blind study was conducted at two institutions; we compared the improved endoscopic purse-string suturing with the technique of monopolar hemostat forceps with soft coagulation for the treatment of peptic ulcer hemorrhage. The primary outcome was the post-procedural re-bleeding rate. The secondary outcomes included initial hemostat success rate, adverse events, volume of transfused blood, cost of hospital stay, and length of hospital stay.ResultsIn total, 114 patients were included in the study, and each patient was randomly assigned to 1 of the 2 treatment groups (each group, n = 57). Procedure time, re-bleeding rates, initial hemostat success rates, duration of hospital stay, volume of transfused blood, and cost of hospital stay were similar between the two groups (p > 0.05). Among the 37 patients with duodenal ulcers, the re-bleeding rate was significantly lower in the improved endoscopic purse-string suturing group (0/21) than in the monopolar hemostat forceps with soft coagulation group (3/16) (p < 0.05).ConclusionThe improved endoscopic purse-string suturing demonstrated a high technical success rate and showed comparable efficacy and safety outcomes to monopolar hemostat forceps with soft coagulation in the treatment of peptic ulcer hemorrhage.Trial Registration: Chinese Clinical Trial Registry, ChiCTR2000034015.