Experimental Justification of Using Aseptisorb-A and Platelet-Rich Plasma in Endoscopic Treatment of Mold Bleeding Stomach Defects

ORIGINAL ARTICLE
Evgeniy F. Cherednikov, PhD, ScD*; Sergey V. Barannikov; Yuri V. Maleev, PhD, ScD; Konstantin O. Fursov; Tatyana E. Litovkina; Evgeniy I. Zakurdaev, PhD; Evgeniy S. Ovsyannikov, PhD

Voronezh State Medical University named after N. N. Burdenko. Voronezh, the Russian Federation

*Corresponding author: Evgeniy S. Ovsyannikov, PhD. Department of faculty therapy, Voronezh State Medical University named after N.N. Burdenko. Voronezh, Russia.  E-mail: ovses@yandex.ru.

Published: December 15, 2017.  doi: 10.21103/Article7(4)_OA5

Abstract: 

The aim of this study was to investigate the possibility of applying the biologically active draining sorbent Aseptisorb-A in combination with platelet-rich plasma (PRP) to arrest bleeding of mold stomach defects in dogs.
Methods and Results: The experimental study was done on 12 outbred dogs (both sexes). Fibrogastroduodenoscopy (FGDS) was performed on all animals under intravenous anesthesia. During FGDS, two ulcerative defects (pilot and control) were made in the antrum of the stomach at 4-5cm distant from each other. Endoscopic hemostasis in pilot ulcers was achieved with the help of pneumatic insufflation of powder-like Aseptisorb-A (0.3mg) on the bleeding defect with further application of platelet-rich autologous plasma from the animal. Endoscopic treatment of control ulcers was not done; such ulcers were used to estimate the time of spontaneous hemostasis. It was determined that in pilot ulcers after described interventions, bleeding arrest occurred in 3.0|2.5|4.0 sec (Ме | upper quartile | lower quartile) (p<0.01). It was noted that in all pilot ulcers, hemostasis was definitive and there was no recurrence of bleeding. In the control ulcers, bleeding arrest occurred in 29.0|27.5|30.5 sec (p≤0.01). In endoscopic gastroscopy, two cases of the reinitiation of haemorrhages in the form of hematin on ulcers were fixed. The reparative process in pilot ulcers treated with Aseptisorb-A and PRP occurred quicker and more efficiently. Complete healing of pilot ulcers occurred in 8.0|8.0|8.5 days (p≤0.01) with formation of a slight sword-cut, which did not destroy the wall of the organ. Complete healing of control ulcers was identified in 15.0|15.0|16.0 days (P<0.01) with formation of a rough scar, which deformed the organ’s wall.
Conclusion: Using the biologically active draining sorbent Aseptisorb-A in combination with PRP in endoscopic treatment of mold bleeding in the defects of stomachs accelerates the reparative process, reduces the time of healing in experimental ulcers, improves the quality of healing and does not damage stomach tissue.

Keywords: 
mold bleeding ● endoscopic hemostasis ● Aseptisorb-A ● platelet-rich plasma ● reparative process
References: 
  1. Pedroto I, Dinis-Ribeiro M, Ponchon T. Is timely endoscopy the answer for cost-effective management of acute upper gastrointestinal bleeding? Endoscopy.2012;44(8):721–2. doi: 10.1055/s-0032-1310064.
  2. Deryaeva OG, Cherednikov EF. Complex treatment of erosive-ulcerative gastroduodenal bleeding in patients multiprofile hospital. Sistemnyj analiz i upravlenie v biomedicinskih sistemah. 2014; 13(3):725-730. [Article in Russian].
  3. Cherednikov EF, Deryaeva OG, Adianov VV, Ovchinnikov IF, Popov ArtV. Modern trends in the prevention and treatment of patients with gastrointestinal hemorrhage in the center. Sistemnyj analiz i upravlenie v biomedicinskih sistemah.  2014;13(2):426-430. [Article in Russian].
  4. Ulcerative gastroduodenal bleeding. National clinical guidelines. Hirurgicheskaja praktika. 2015;2:62-64. [Article in Russian].
  5. Starkov YG, Domarev LV, Shitnikov EA, Russkih AE, Svitina KA. Characteristics and effectiveness of various methods of endoscopic hemostasis for peptic ulcer bleeding.  Hirurgija v gastrojenterologii. 2014;6: 34-37. [Article in Russian].
  6. Cherednikov EF, Kashurnikova MA, Romantsov MN, Barannikov SV, Bolokhovitinov AE, Gaponenkov DG, Lyubimov PYu. Experimental study of new means of local hemostasis in the treatment of ulcerative bleedings. Nauchno-medicinskij vestnik Central'nogo Chernozem'ja. 2016;65:27-33. [Article in Russian].
  7. Cherednikov EF, Deryaeva OG, Cherednikov EE, Aianov VV, Bondarenko AA, Yakushev FK. The effectiveness of a modern approach to the treatment of patients with gastroduodenal bleeding in a multi-hospital. Nauchno-medicinskij vestnik Central'nogo Chernozem'ja.  2016; 65: 20-25. [Article in Russian].
  8. Budnevsky AV, Popov ArtV, Cherednikov EF. Erosive-ulcerative defeat stomach and duodenal ulcers in medical patients: prevention of bleeding. Nauchno-medicinskij vestnik Central'nogo Chernozem'ja. 2016;65:64-71. [Article in Russian].
  9. Cherednikov EF.  The fifteen years of experience in the treatment of patients with ulcerative gastroduodenal bleeding. Zhurnal teoreticheskoj i prakticheskoj mediciny. 2008;5(4):372. [Article in Russian].
  10. Cherednikov EF, Stepanyan NA, Lyubykh E N. Morphological modeling of stomach ulcers in the treatment of hydrogels. Novosti klinicheskoj citologii Rossii. 1988;(2):66. [Article in Russian].
  11. Cherednikov EF, Batkaev AR, Baev VE. The reparative regeneration of erosive-ulcerative lesions of the stomach and duodenum in the local treatment of hydrophilic granular sorbents. Sistemnyj analiz i upravlenie v biomedicinskih sistemah.  2005;4(2)224-5. [Article in Russian].
  12. Koreyba KA, Usmanov MA, Minabutdinov AR. Sorbents "ASEPTISORB" for patients with diabetic foot syndrome. Prakticheskaya medicina. 2014; 5(81):143-151. [Article in Russian].
  13. Cherednikov EF, Popov AV, Kashurnikova MA, Adianov VV, Ovchinnikov IF, Deryaeva OG, Popov AV. Method of endoscopic treatment of gastroduodenal ulcers. Voronezh State Med Academy NN. Burdenko. 2013: 25322492(31). [in Russian].
  14. Adianov VV, Cherednikov EF. Optimization of the treatment of gastroduodenal bleedings in patients with high operational risk. Sistemnyj analiz i upravlenie v biomedicinskih sistemah. 2014;13(4)841-6. [Article in Russian].
  15. Baev VE, Kravets BB, Cherednikov EF. Diagnosis of ulcerative forms of stomach cancer. Voronezh: Publishing house of Voronezh State University; 2003:110 pp.[in Russian].
  16. Cherednikov ЕF, Kunin AA, Cherednikov EE, Moiseeva NS. The role of etiopathogenetic aspects in prediction and prevention of discontinuous-hemorrhagic (Mallory-Weiss) syndrome. EPMA J. 2016;7:7. doi: 10.1186/s13167-016-0056-4.
  17. Shalimov SA, Radzikhovskiy AP, Keysevich LV. Manual on experimental surgery. Moskva: Medicina; 1989:175-176. [in Russian].
  18. Cherednikov EF, Gryaznov VN, Baev VE, Gaponenkov DG. Modeling of a bleeding stomach ulcer. Problemy sudebnoy mediciny i klinicheskoy praktiki. 1994:17-18. [Article in Russian].
  19. Aruin LI. The quality of healing of gastroduodenal ulcers: functional morphology, the role of methods of pathogenetic therapy. Suchasna gastrojenterologija. 2013: 5 (73): 92-103.[Article in Russian].

The fully formatted PDF version is available.
Download Article
International Journal of Biomedicine. 2017;7(4):298-301. ©2017 International Medical Research and Development Corporation. All rights reserved.