A RANDOMIZED STUDY OF INJECTION-HEMOCLIPPING COMPARED TO INJECTION-MULTIPOLAR

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. SPECIFIC AIMS 1. To compare the efficacy and safety of two endoscopic combination therapies (epinephrine injection plus either multipolar probe or hemoclipping) for hemostasis of non-variceal, non-malignant, or non-angiomatous colonic hemorrhage. 2. To compare the proportion of lesions with a significant decrease in size from baseline at 3 weeks colonoscopy or flexible sigmoidoscopy (if in distal colon). 3. To quantitate and compare endoscopic lesion sizes (diameter and depth) before vs. immediately after endoscopic treatments; and before endoscopic treatment vs. 3 weeks on colonoscopy (or flexible sigmoidoscopy). 4. To quantitate and compare routine outcomes after endoscopic hemostasis with the two different treatments, including primary and permanent hemostasis rates; rates of treatment failure and crossover to the other treatment (for failure of acute hemostasis, severe rebleeding necessitating retreatment, or a severe treatment complication); transfusions (units red blood cells, platelets, and fresh frozen plasma- total and post-randomization); duration of hospital and intensive care unit stay; complications; surgery; and mortality rates at 7 and 30 days after randomization. 5. To estimate and compare direct costs of care, after randomization of patients. 6. To record, edit, and archive digital images and videoclips of study cases for publication and teaching purposes.