Prevention of late complications with coverage agents in endoscopic resection of colorectal lesions: Current landscape in gastrointestinal endoscopy

Table 1 Outcome of coverage agents to prevent delayed bleeding and perforation after endoscopic resection of colorectal lesions

Ref.	Year	Design	n	Size (mm)	Agent	Primary endpoint	Follow-up	Outcomes
Tsuji et al[10]	2014	SA	10	39.7	PGA-FG	Prevent late complications	2 wk	0% DB/0% DP
Myung et al[13]	2016	SA	49	38.8	Surgicel	Prevent late complications	1 wk	0% DB/0% DP/6% PPS
Lorenzo-Zúñiga et al[17]	2021	SA	4	53.7	PRP	Prevent late complications	4 wk	25% DB/0% DP/79% MHR
Pioche et al[18]	2016	SA	22	38.5	Purastat	Prevent delayed bleeding	4 wk	6.7% DB
Subramanian et al[19]	2019	SA	31	44.2	Purastat	Prevent delayed bleeding	4 wk	0% DB
Soons et al[20]	2020	SA	17	38.4	Purastat	Prevent delayed bleeding	4 wk	11.7% DB
Subramanian et al[21]	2021	RCT	43	33.7	Purastat	Prevent late complications	4 wk	5.5% DB
Martines et al[22]	2020	TA	15	25	NBCA-MS	Prevent delayed bleeding	-	0% DB

SA: Single-arm interventional case series study; TA: Two-arm interventional case series study; RCT: Randomized clinical trial; PGA-FG: Polyglycocolic acid sheet with fibrin glue; PRP: Platelet-rich plasma; NBCA-MS: N-butyl-2-cyanoacrylate with methacrylosulfolane (Glubran 2); DB: Delayed bleeding; DP: Delayed perforation; MHR: Mucosal healing rate.

Table 2 Pros and cons of coverage agents based on ideal properties

Property	PGA-FG	Surgicel	PRP	Purastat	Cyanoacrylate
Appropriate adhesion capacity	+	+	+	+	+
Absence of special device	-	+	+	-	+
Not time-consuming	-	+	+	+	+
Refractory to bacterial degradation	+	+	-	-	+
Healing activity	+	+	+	+	+
Price range of 1 mL ($)	20-25	15-20	10-12	100-150	150
Drug-release	-	-	-	-	-

PGA-FG: Polyglycocolic acid sheet with fibrin glue; PRP: Platelet-rich plasma.