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Abstract
Abstract Background An emerging non-contact endoscopic method for hemostasis is the use of spray coagulation (SC) using a polypectomy snare tip. Other non-contact options, such as argon plasma coagulation (APC), can be inconvenient and costly. Our current practice includes using SC where APC would be traditionally indicated. Aims The aim of this study was to characterize the clinical outcomes, including rates of successful hemostasis, rebleeding, and complications, for snare tip SC in hemostasis. Methods We conducted a retrospective chart review of all patients who underwent therapeutic endoscopy for hemostasis using snare tip SC by a single operator at a large Canadian tertiary care centre between January 2018 and September 2020. Results 14 patients, including 10 males and 4 females, were included. 5 (35%) patients received SC during an EGD, 5 (35%) patients during a colonoscopy, and 4 (29%) patients during a small bowel enteroscopy. Mean age was 74.4 (±11). All patients were referred for work-up of gastrointestinal bleeding or anemia. 5 (35%) patients were treated for vascular lesions including AVMs or angioectasias, 4 (29%) patients for GAVE, 3 (21%) patients for radiation proctitis, and 2 (14%) patients for bleeding ulcers. Adequate hemostasis, defined by cessation of bleeding symptoms, lack of a 10g/L or more decrease in hemoglobin post-procedure, and no further endoscopic therapies in the subsequent 28 days, was achieved in 11 patients (79%). 2 of the 3 patients in which adequate hemostasis was not achieved had additional investigations in which a second source of bleeding was found and treated. 1 patient with colonic AVMs and 1 patient with radiation proctitis required a repeat treatment in 2 weeks and 6 months, respectively. There were no incidence of prolonged abdominal pain, perforations or deaths. Conclusions Snare tip spray coagulation appears to be a safe and effective modality for non-contact hemostasis. Larger studies will help solidify its use in daily practice. Funding Agencies None
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