Electricity Stems Bleeding in Tests on Ulcer Patients
A USC researcher has found a promising non-surgical way to treat life-threatening bleeding ulcers by coagulating the blood with electrical current.
In a report in this week’s New England Journal of Medicine, Dr. Loren Laine said patients treated with this technique, called multipolar electrocoagulation, required less than half as much blood and had to spend fewer days in the hospital.
In addition, he said, the cost of care was less than half the $7,550 for bleeding ulcer patients at County-USC Medical Center who were treated in the standard way.
More than 300,000 people are hospitalized each year in the United States for bleeding in the upper gastrointestinal tract. Most of these are for ulcers in the stomach. For the 80% in whom bleeding stops spontaneously, the mortality rate is about 4%. But for the remainder, the mortality rate from emergency surgery can be as high as 20%.
Laser Beam Ineffective
In a related article in the same journal, doctors from Dallas and Houston report on the results of another study to stop such hemorrhaging by burning the tissue with a laser beam. But they concluded that this method was of no benefit to their patients.
The USC and Texas reports are the latest in at least 16 recent studies to test either electricity or laser beams in the treatment of bleeding ulcers, but the results have been inconclusive.
Laine, however, said he is confident that the electrocoagulation method is an advance over standard treatment. “It is safe and it seems to work.”
The procedure is performed at the same time that the patient’s problem is diagnosed by observing the ulcer through a fiber-optic tube, called an endoscope, that is passed into the stomach. If the treatment does not work, Laine said, the patient can still be sent quickly to surgery for an emergency operation.
High Success Rate
In his study, 44 patients were divided into two groups, with 21 of them receiving electrocoagulation therapy and 23 not receiving it. Coagulation halted bleeding in all but two patients, Laine said. But 20 of the 23 in the other group continued to bleed and 13 of them required emergency surgery, compared to three in the treated group.
The unsuccessful laser study was conducted by Dr. Guenter J. Krejs of the University of Texas Health Sciences Center in Dallas on 85 peptic ulcer patients.
Despite the promising USC results, it still is not possible to say that Laine’s method is better than the laser, according to Dr. David Fromm of Syracuse University in an editorial accompanying the two reports. He said both procedures should be further evaluated.
