Experimental and clinical rationale for the gastrointestinal bleeding treatment with endoscopic high frequency welding bipolar electrocoagulation

Abstract

Problem of gastrointestinal bleeding treatment remains relevant, due to the high mortality. Endoscopic haemostasis reduces both general and postoperative mortality 3 — 4 times. There are a number of methods for endoscopic haemostasis: chemical, injectable, monopolar coagulation, argon plasma coagulation, laser coagulation and clapping.The aim — to substantiate experimentally and morphologically the use of high­frequency welding bipolar electrocoagulation with the EK­300M1 apparatus in gastrointestinal bleeding endoscopic treatment and introduce it into clinical practice.Materials and methods. An experimental study of a new local haemostasis method for bleeding vessels and erosions (patent N 124885 dated 25.04.2018, A method for treating patients with gastrointestinal bleeding) with morphological verification of the state of the vessels was done with experimental study on 10 pigs aged 5 — 7 years, weighing 85 — 100 kg. For high­frequency welding bipolar coagulation, two probes were used, connected to the EK­300 M1 apparatus in the overlap mode: 2.2 mm in diameter (patent N 115147 dated 04.04.2017) with a convex electrode (N 1) and 3.2 mm (modified) with a concave electrode (N 2).Results and discussion. It has been established that to stop bleeding from vessels with a diameter of up to 1 mm, it is most effective to use probe N 1 with an exposure time of 15 s; for vessels with a diameter of more than 1 mm­ probe N 2 with an exposure time of 30 s.Conclusions. High­frequency welding bipolar electrocoagulation has advantages over other methods of endoscopic haemostasis and can be recommended as the method of choice for the gastrointestinal.