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- Title
Different clinical characteristics associated with acute bleeding and delayed bleeding after endoscopic submucosal dissection in patients with early gastric cancer.
- Authors
Yano, Takafumi; Tanabe, Satoshi; Ishido, Kenji; Suzuki, Mizuto; Kawanishi, Natsuko; Yamane, Sakiko; Watanabe, Akinori; Wada, Takuya; Azuma, Mizutomo; Katada, Chikatoshi; Koizumi, Wasaburo
- Abstract
<bold>Background/aims: </bold>Few studies have classified risk factors according to the onset time of bleeding after endoscopic submucosal dissection (post-ESD bleeding).<bold>Methods: </bold>We studied 1767 consecutive lesions in patients who underwent ESD for early gastric cancer from December 2006 through June 2016. Patients who had a remnant stomach or who had undergone reconstruction with a gastric tube were excluded. Post-ESD bleeding was classified into acute bleeding (0-5 days after ESD) and delayed bleeding (6 or more days after ESD), and the risk factors for each type of bleeding were compared.<bold>Results: </bold>Post-ESD bleeding occurred in 150 (8.5%) of 1767 lesions. Bleeding was acute in 129 lesions (7.3%) and delayed in 21 (1.2%). Acute post-ESD bleeding was frequently associated with lesions located in the distal stomach, expanded indications or non-indicated lesions, a specimen diameter of ≥40 mm, and antithrombotic therapy. Delayed post-ESD bleeding was often associated with lesions located in the proximal stomach, hemodialysis, and antithrombotic therapy. Among 334 lesions in patients who received antithrombotic therapy, post-ESD bleeding occurred in 47 lesions (14.1%). Independent risk factors for post-ESD bleeding were a specimen diameter of ≥40 mm and treatment with 2 or more antithrombotic agents.<bold>Conclusions: </bold>Acute post-ESD bleeding and delayed post-ESD bleeding were associated with different clinical characteristics. Antithrombotic therapy is a risk factor for post-ESD bleeding in both the acute and delayed phases.
- Subjects
GASTRIC diseases; ENDOSCOPY; DISEASE risk factors; TISSUE wounds; HEMORRHAGE; THERAPEUTIC use of fibrinolytic agents; GASTRIC mucosa; FIBRINOLYTIC agents; LONGITUDINAL method; STOMACH tumors; SURGICAL complications; TIME; DISEASE incidence; RETROSPECTIVE studies; SURGERY
- Publication
Surgical Endoscopy & Other Interventional Techniques, 2017, Vol 31, Issue 11, p4542
- ISSN
1866-6817
- Publication type
journal article
- DOI
10.1007/s00464-017-5513-1