Endoscopic application of autologous platelet rich plasma on gastric ulcer after endoscopic submucosal dissection: A pilot study

Abstract

Background and Aim: Platelet‐rich plasma (PRP) is a concentrate of platelet‐rich plasma protein derived from whole blood, centrifuged to remove red blood cells. Although PRP has been shown to promote healing and regeneration in various of tissue, little is known about its effect on gastric ulcer. This study aimed to investigate the efficacy of endoscopic application of autologous PRP on artificial gastric ulcer after endoscopic submucosal dissection (ESD). Methods: Prospective randomized placebo‐controlled trial was conducted at a single tertiary hospital. Consecutive patients who underwent ESD for gastric neoplasm were randomly assigned to the PRP or control group. Immediately after ESD, prepared autologous PRP or saline was applied to artificial ulcer. The ulcer diameter was measured immediately after ESD, 2nd weeks, and 4th weeks after the procedure using endoscopic ruler. The efficacy of PRP was evaluated based on the ulcer size and the occurrence of post ESD complications between the two groups. Results: Overall, twenty patients were enrolled in this pilot study (PRP group 10, control 10, age, mean ± SD, 61.00 ± 10.15, male 11). The mean size of long diameter of ulcer immediately after ESD was significantly larger in the PRP group than in the control (51.00 ± 11.26 vs. 38.50 ± 8.52, p = 0.012). When the changes in ulcer size were compared between the two groups, the mean ulcer size decreased more in the PRP group than in the control group at 2 weeks (1648.20 ± 1004.66 vs. 851.60 ± 502.53, p = 0.043) and 4 weeks (1898.20 ± 1021.18, 1096.30 ± 553.40, p = 0.047) after ESD. Post ESD bleeding rate was not different between the groups. No adverse events related to the application of PRP were occurred. Conclusion: Endoscopic application of PRP may be effective treatment modality for artificial gastric ulcers after ESD.