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- Title
Risk factors and correlations of immediate, early delayed, and late delayed bleeding associated with endoscopic resection for gastric neoplasms.
- Authors
Park, So-Eun; Kim, Do; Jung, Hwoon-Yong; Lim, Hyun; Ahn, Ji; Choi, Kwi-Sook; Lee, Jeong; Choi, Kee; Song, Ho; Lee, Gin; Kim, Jin-Ho; Han, Seungbong; Kim, Do Hoon; Ahn, Ji Yong; Lee, Jeong Hoon; Choi, Kee Don; Song, Ho June; Lee, Gin Hyug
- Abstract
<bold>Background: </bold>Bleeding is a major complication following endoscopic resection (ER) of gastric mucosal lesions. We aimed to determine the risk factors for post-ER bleeding and their correlations according to the time elapsed since the procedure.<bold>Methods: </bold>We retrospectively enrolled 670 lesions in 610 patients who underwent ER between March 2009 and December 2010. We classified these lesions into three types in accordance with the bleeding time, i.e., immediate bleeding (IB), early delayed bleeding (EDB), and late delayed bleeding (LDB). We analyzed the risk factors for each bleeding type according to baseline patient characteristics, procedure-related factors, and correlations between the occurrence of each bleeding type.<bold>Results: </bold>There were 408 post-ER bleeding events in our study cohort: 302 IB events, 88 EDB events, and 18 LDB events. In multivariate analysis, a histologic finding of carcinoma and the resection time were significant predictors of IB (p < 0.001). Of the 302 IB events, 13.9% showed EDB. Additionally, LDB occurred in 2.4% of lesions with EDB and 4.6% of lesions without EDB. Similar to the IB group, of 368 lesions without IB, 12.5% showed EDB. In addition, LDB occurred in 2.2% of lesions with EDB and 1.2% of lesions without EDB. IB was associated with a higher risk of EDB (p < 0.001) and LDB (p < 0.001), whereas EDB was not related to an increased risk of LDB (p = 0.997).<bold>Conclusion: </bold>IB significantly increases the risk of EDB and LDB, but EDB does not increase the risk of LDB. Histologically confirmed carcinoma or a prolonged time for resection increases the risk of post-ER IB. We recommend careful follow-up approaches following ER of a gastric mucosal lesion in high-risk patients to prevent a potentially critical occurrence of delayed bleeding.
- Subjects
STOMACH surgery complications; STOMACH cancer; HEMORRHAGE risk factors; ENDOSCOPIC surgery; LAPAROSCOPIC surgery; ONCOLOGIC surgery; GASTRIC mucosa; ENDOSCOPY; GASTROSCOPY; HEMORRHAGE; LONGITUDINAL method; MULTIVARIATE analysis; REGRESSION analysis; STOMACH tumors; SURGICAL complications; TIME; RETROSPECTIVE studies; ODDS ratio; SURGERY
- Publication
Surgical Endoscopy & Other Interventional Techniques, 2016, Vol 30, Issue 2, p625
- ISSN
1866-6817
- Publication type
journal article
- DOI
10.1007/s00464-015-4250-6