| [Purpose] PuraStat (3-D matrix), a self-assembling peptide, was released for intraoperative bleeding during gastrointestinal endoscopy. In this study, we investigated the effect of PuraStat on perioperative bleeding in colorectal cold snare polypectomy (CSP) in patients with antithrombotic drugs. [Methods] This study was a single-center observational study. The subjects were patients with anticoagulant therapy or thienopyridine antiplatelet therapy, receiving CSP for colorectal polyps of 2-10 mm from 2021 to 2023. Patients who had continuous perioperative bleeding and were treated with PuraStat were analyzed. [Results] A total of 109 lesions were analyzed. The rates of lesions with DOAC, warfarin, and thienopyridines were 48.6%/26.6%/24.8% (53/29/27). The site was right colon/left colon/rectum: 76.1%/22.0%/1.8% (83/24/2), and the average lesion size was 4.3 mm. Histopathology was adenoma/serrated lesion 87.2%/22.8% (95/14). Hemostasis rate of perioperative bleeding by PuraStat was 89.0% (97 lesions). A 3ml formulation of PuraStat could be applied to a maximum of 10 lesions. Of the 12 lesions where hemostasis could not be achieved, hemostasis was achieved by clipping in all cases. Postoperative bleeding rate was 0% [95%CI: 0-4.0%]. [Conclusion] In patients with antithrombotic drugs receiving CSP, the hemostasis rate of PuraStat was favorable at 89.0%. Furthermore, the possibility of preventive effect against postoperative bleeding was suggested. |
