P2461 - The Efficacy of Hemospray in Managing Bleeding Related to Gastrointestinal Tumors: Systematic Review and Meta-Analysis

Hazem Abosheaishaa, MD¹, Abdallfatah Abdallfatah, ², Ahmed Elhawary, MD¹, Omar T. Ahmed, MD³, Khaled Elfert, MD⁴, Islam Mohamed, MD⁵, Iyiad AlabdulRazzak, MD⁶, Monzer Abdalla, MD⁷, Mohammed Abusuliman, MD⁸, Arshia Sethi, MD¹, Ahmed E. Salem, MBBCh⁹, Omar Abdelhalim, MD¹, Vijay Reddy Gayam, MD¹⁰, Saphwat L. Eskaros, MD¹¹, Brian R. Boulay, MD, MPH^12
1Icahn School of Medicine at Mount Sinai, Queens, NY; ²October 6 University, Cairo, Al Jizah, Egypt; ³University of Illinois at Chicago, Chicago, IL; ⁴West Virginia University, Morgantown, WV; ⁵University of Missouri - Kansas City School of Medicine, Kansas City, MO; ⁶St. Elizabeth's Medical Center, Boston, MA; ⁷Ascension Saint Francis Hospital, Evanston, IL; ⁸Henry Ford Health, Detroit, MI; ⁹Maimonides Medical Center, Brooklyn, NY; ¹⁰University of Texas Southwestern Medical Center, Dallas, TX; ¹¹Queens Hospital Center, Jamaica, NY; ¹²University of Illinois, Chicago, IL

Introduction: Gastrointestinal (GI) bleeding stemming from malignant tumors is increasingly recognized due to advancements in oncology and detection methods. Traditional endoscopic hemostatic techniques have shown variable success rates in managing hemorrhagic GI neoplasms. Hemospray, an emerging endoscopic hemostatic powder, offers promise in treating upper GI bleeding, potentially extending its utility to neoplastic bleeding sites. This meta-analysis aims to evaluate Hemospray's efficacy in managing bleeding related to gastrointestinal tumors.

Methods: Database search including Embase, Scopus, Web of Science, Medline/PubMed, and Cochrane was done until January 03, 2024, using Boolean search strategies with the terms "Hemospray" OR "Hemostatic powder" OR "TC 325") AND ("Gastrointestinal bleeding" OR "GI bleeding") AND ("Malignancy" OR "Neoplasm" OR "Cancer". Inclusion criteria encompassed studies focusing on malignancy-related GI bleeding and interventions utilizing Hemospray. Comparative studies contrasted Hemospray with standard endoscopic treatments (SET), while non-comparative studies assessed Hemospray's efficacy independently. The risk of bias was assessed using appropriate tools, and statistical analyses were performed using Review Manager and open Meta analyst software.

Results: Initial searches yielded 327 articles, with 19 included in the meta-analysis, comprising 930 patients. Hemospray demonstrated higher rates of immediate hemostasis compared to SET (OR: 17.14, 95% CI: 4.27-68.86), with consistent outcomes across studies. Rebleeding rates at 14 and 30 days were comparable between Hemospray and SET groups, suggesting similar efficacy in long-term hemostasis. Hemospray showed a significantly lower need for non-endoscopic hemostasis compared to SET (OR: 0.51, 95% CI: 0.30-0.87), indicating a potential reduction in supplementary interventions. Safety assessments revealed no confirmed adverse events directly linked to Hemospray.

Discussion: This meta-analysis highlights Hemospray's efficacy in achieving immediate hemostasis in GI tumor-related bleeding, with potential benefits in reducing supplementary interventions and improving patient outcomes. Despite comparable rebleeding rates, Hemospray emerges as a valuable adjunctive therapy in managing malignant GI bleeding.



Disclosures:


Hazem Abosheaishaa, MD¹, Abdallfatah Abdallfatah, ², Ahmed Elhawary, MD¹, Omar T. Ahmed, MD³, Khaled Elfert, MD⁴, Islam Mohamed, MD⁵, Iyiad AlabdulRazzak, MD⁶, Monzer Abdalla, MD⁷, Mohammed Abusuliman, MD⁸, Arshia Sethi, MD¹, Ahmed E. Salem, MBBCh⁹, Omar Abdelhalim, MD¹, Vijay Reddy Gayam, MD¹⁰, Saphwat L. Eskaros, MD¹¹, Brian R. Boulay, MD, MPH¹². P2461 - The Efficacy of Hemospray in Managing Bleeding Related to Gastrointestinal Tumors: Systematic Review and Meta-Analysis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.