Korean J Gastrointest Endosc.  2004 Dec;29(6):489-494.

The Effects of Endoscopic Sodium Alginate Powder (Alto Shooter(TM)) in Peptic Ulcer Bleeding

• Baek I
• Oh HY
• Baik GH
• Hahn T
• Kim JB
• Lee J
• Lee MS

Abstract

BACKGROUND/AIMS
Peptic ulcer bleeding can be treated by endoscopic laser, argon plasma coagulation, heater probe, or electrocoagulation. However, techinical difficulties and significant rebleeding rate after such endoscopic hemostasis, offer some beneficial effect of Alto Shooter(TM) as an adjuvant therapy in active peptic ulcer bleeding.
METHODS
Twenty-three patients with active peptic ulcer bleeding were randomized to Alto Shooter(TM) & argon plasma coagulation therapy (ALTO+APC) or argon plasma coagulation therapy alone (APC). Forrest classifications were used to compare the effect of bleeding control.
RESULTS
The Forrest classifications in two groups before treatment were Ib (6 patients), IIa (11 patients) in "ALTO+APC", Ib (2 patients) and IIa (4 patients) in "APC". The Forrest classifications of two groups at follow-up endoscopy were Ia (1 patient), Ib (1 patient), IIc (14 patients), III (1 patient) in "ALTO+APC" and IIc (6 patients) in "APC". There was no significant difference in hemostatic effect between "ALTO+APC" (p=0.001) and "APC" (p=0.001) groups.
CONCLUSIONS
Alto Shooter(TM) offers no advantage over conventional endoscopic argon plasma coagulation therapy in controlling active peptic ulcer bleeding. Therefore routine addition of Alto ShooterTM treatment may not be recommended after initial successful endoscopic argon plasma coagulation therapy in active peptic ulcer bleeding.

Keyword

Peptic ulcer bleeding; Sodium alginate; Alto Shooter(TM); Argon plasma coagulation therapy (APC)

MeSH Terms

Argon Plasma Coagulation
Classification
Electrocoagulation
Endoscopy
Follow-Up Studies
Hemorrhage*
Hemostasis, Endoscopic
Humans
Peptic Ulcer*
Sodium*
Sodium