Endoscopic Shielding With Platelet-rich Plasma After Resection Of Large Colorectal Lesions

Surg Laparosc Endosc Percutan Tech. 2021 Feb 3;31(3):376-377. doi: 10.1097/SLE.0000000000000898.

Abstract

Background: Platelet-rich plasma (PRP) has demonstrated efficacy as submucosal injection before endoscopic mucosal resection or local injection after endoscopic submucosal dissection of nonpedunculated colorectal lesions.

Methods: The EndoPRP study was a prospective single-center study to analyze the efficacy of PRP shield after endoscopic mucosal resection of large nonpedunculated colorectal lesio with impossible clip closure, assessed by the incidence of delayed bleeding (DB) and delayed perforation, and percentage of mucosal restoration after 4 weeks (mucosal healing rate).

Results: Shielding technique with PRP was performed in 4 patients, aged 52 to 80, with 4 lesions at rectum (mean size 53.7±20.6 mm, range 35 to 80 mm). DB occurred in 1 lesion (25% of all lesions), no required blood transfusion or endoscopic treatment. No postoperative delayed perforation occurred. Mucosal healing rate was of 78.6% after 4 weeks.

Conclusions: PRP shield failed in prevent DB, probably due to migration and failure in the adherence in large wounds. Future comparative studies are needed to confirm these data.

MeSH terms

  • Colorectal Neoplasms* / surgery
  • Endoscopic Mucosal Resection*
  • Humans
  • Platelet-Rich Plasma*
  • Prospective Studies
  • Surgical Instruments
  • Treatment Outcome