Endoscopic transparent cap assisted hemostasis: A multicenter retrospective cohort study
World Journal of Gastroenterology, cilt.32, sa.15, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 32 Sayı: 15
- Basım Tarihi: 2026
- Doi Numarası: 10.3748/wjg.v32.i15.116083
- Dergi Adı: World Journal of Gastroenterology
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE
- Anahtar Kelimeler: Charlson Comorbidity index, Endoscopic hemostasis, Hemostatic efficacy, Multicenter retrospective study, Non-variceal upper gastrointestinal bleeding, Transfusion requirement, Transparent cap
- Ondokuz Mayıs Üniversitesi Adresli: Evet
Özet
BACKGROUND Non-variceal upper gastrointestinal bleeding (NVUGIB) remains a common and potentially life-threatening emergency despite advances in endoscopic therapy. Endoscopic transparent caps (CAPs) have been proposed to enhance lesion visualization and procedural stability, but their effect on clinical outcomes is uncertain. AIM To evaluate whether CAP use during therapeutic endoscopy influences hemostatic efficacy and short-term outcomes in NVUGIB. METHODS A total of 206 patients who underwent emergency endoscopic hemostasis between 2021 and 2025 at six tertiary centers in Türkiye were included. Patients were divided into CAP-assisted (n = 67) and non-CAP (n = 139) groups. Baseline characteristics, comorbidities, Glasgow-Blatchford and Rockall scores, hemostatic methods, and clinical outcomes were analyzed. Multivariable linear regression identified independent predictors of post-admission transfusion requirement and hospital length of stay (LOS). RESULTS Baseline demographic and clinical variables were comparable between groups. CAP was more often used in hemodynamically unstable patients. The CAP group required a greater number of hemostatic techniques (2.66 ± 1.00 vs 2.14 ± 0.87; P < 0.001), with higher use of Ankaferd Blood Stopper and argon plasma coagulation, but received fewer post-admission transfusions (14.8 % vs 33.8 %; P = 0.006) and a lower transfusion volume (0.44 ± 1.13 U vs 0.91 ± 1.31 U; P = 0.012). Mortality, intensive-care need, and LOS did not differ significantly. CAP use independently predicted reduced transfusion volume (β = -0.47, P = 0.010), whereas higher Charlson Comorbidity index and intensive care unit admission predicted longer LOS. CONCLUSION CAP-assisted endoscopy may improve procedural efficiency and hemostatic control in NVUGIB, reducing transfusion requirements without affecting mortality or hospitalization. Prospective randomized trials are warranted to validate these findings and clarify CAP’s role in standardized bleeding management.