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Clinical Impact of Second-Look Endoscopy after Endoscopic Submucosal Dissection of Gastric Neoplasms

BACKGROUND/AIMS: One major complication of endoscopic submucosal dissection (ESD) is delayed bleeding. Most hospitals routinely perform second-look endoscopy to reduce the chances of delayed bleeding without solid evidence supporting the practice. The aim of this study was to evaluate whether second...

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Autores principales: Kim, Hyung Hun, Park, Seun Ja, Park, Moo In, Moon, Won
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society of Gastroenterology; the Korean Society of Gastrointestinal Endoscopy; the Korean Association for the Study of the Liver; the Korean Society of Neurogastroenterology and Motility; Korean Association for the Study of Intestinal Diseases; Korean College of Helicobacter and Upper Gastrointestinal Research; Korean Pancreatobiliary Association; Korean Society of Gastrointestinal Cancer 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3404167/
https://www.ncbi.nlm.nih.gov/pubmed/22844558
http://dx.doi.org/10.5009/gnl.2012.6.3.316
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author Kim, Hyung Hun
Park, Seun Ja
Park, Moo In
Moon, Won
author_facet Kim, Hyung Hun
Park, Seun Ja
Park, Moo In
Moon, Won
author_sort Kim, Hyung Hun
collection PubMed
description BACKGROUND/AIMS: One major complication of endoscopic submucosal dissection (ESD) is delayed bleeding. Most hospitals routinely perform second-look endoscopy to reduce the chances of delayed bleeding without solid evidence supporting the practice. The aim of this study was to evaluate whether second-look endoscopy prevents delayed bleeding and to verify the clinicopathological features of delayed bleeding to determine how to identify lesions that may require second-look endoscopy. METHODS: We investigated 440 lesions in 397 patients who underwent ESD for gastric neoplasm from January 2008 to June 2010. Two-thirds of the enrolled cases were adenomas, and 290 lesions were located in the lower portion of the stomach. Clinically evident bleeding from mucosal defects 24 hours after ESD was considered as delayed bleeding. We reviewed the data, including the characteristics of patients, lesions, and procedures. Furthermore, the rate of delayed bleeding before and after second-look endoscopy, performed within three days of ESD, was investigated to determine the utility of second-look endoscopy. RESULTS: Delayed bleeding was evident in 9 of 440 lesions (2.0%), all of which underwent endoscopic hemostasis. The only significant factor predicting delayed bleeding was resected specimen over 40 mm in size (p=0.003). Delayed bleeding occurred in 8 of 9 cases (89%) before the second-look endoscopy, which was performed within 72 hours after ESD. CONCLUSIONS: In this study, second-look endoscopy may be useful for preventing post-ESD bleeding, especially when resected specimens are over 40 mm in size.
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spelling pubmed-34041672012-07-27 Clinical Impact of Second-Look Endoscopy after Endoscopic Submucosal Dissection of Gastric Neoplasms Kim, Hyung Hun Park, Seun Ja Park, Moo In Moon, Won Gut Liver Original Article BACKGROUND/AIMS: One major complication of endoscopic submucosal dissection (ESD) is delayed bleeding. Most hospitals routinely perform second-look endoscopy to reduce the chances of delayed bleeding without solid evidence supporting the practice. The aim of this study was to evaluate whether second-look endoscopy prevents delayed bleeding and to verify the clinicopathological features of delayed bleeding to determine how to identify lesions that may require second-look endoscopy. METHODS: We investigated 440 lesions in 397 patients who underwent ESD for gastric neoplasm from January 2008 to June 2010. Two-thirds of the enrolled cases were adenomas, and 290 lesions were located in the lower portion of the stomach. Clinically evident bleeding from mucosal defects 24 hours after ESD was considered as delayed bleeding. We reviewed the data, including the characteristics of patients, lesions, and procedures. Furthermore, the rate of delayed bleeding before and after second-look endoscopy, performed within three days of ESD, was investigated to determine the utility of second-look endoscopy. RESULTS: Delayed bleeding was evident in 9 of 440 lesions (2.0%), all of which underwent endoscopic hemostasis. The only significant factor predicting delayed bleeding was resected specimen over 40 mm in size (p=0.003). Delayed bleeding occurred in 8 of 9 cases (89%) before the second-look endoscopy, which was performed within 72 hours after ESD. CONCLUSIONS: In this study, second-look endoscopy may be useful for preventing post-ESD bleeding, especially when resected specimens are over 40 mm in size. The Korean Society of Gastroenterology; the Korean Society of Gastrointestinal Endoscopy; the Korean Association for the Study of the Liver; the Korean Society of Neurogastroenterology and Motility; Korean Association for the Study of Intestinal Diseases; Korean College of Helicobacter and Upper Gastrointestinal Research; Korean Pancreatobiliary Association; Korean Society of Gastrointestinal Cancer 2012-07 2012-05-02 /pmc/articles/PMC3404167/ /pubmed/22844558 http://dx.doi.org/10.5009/gnl.2012.6.3.316 Text en Copyright © 2012 by the Korean Society of Gastroenterology, the Korean Society of Gastrointestinal Endoscopy, the Korean Society of Neurogastroenterology and Motility, Korean College of Helicobacter and Upper Gastrointestinal Research, Korean Association for the Study of Intestinal Diseases, the Korean Association for the Study of the Liver, Korean Pancreatobiliary Association, and Korean Society of Gastrointestinal Cancer http://creativecommons.org/licenses/by-nc/3.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Kim, Hyung Hun
Park, Seun Ja
Park, Moo In
Moon, Won
Clinical Impact of Second-Look Endoscopy after Endoscopic Submucosal Dissection of Gastric Neoplasms
title Clinical Impact of Second-Look Endoscopy after Endoscopic Submucosal Dissection of Gastric Neoplasms
title_full Clinical Impact of Second-Look Endoscopy after Endoscopic Submucosal Dissection of Gastric Neoplasms
title_fullStr Clinical Impact of Second-Look Endoscopy after Endoscopic Submucosal Dissection of Gastric Neoplasms
title_full_unstemmed Clinical Impact of Second-Look Endoscopy after Endoscopic Submucosal Dissection of Gastric Neoplasms
title_short Clinical Impact of Second-Look Endoscopy after Endoscopic Submucosal Dissection of Gastric Neoplasms
title_sort clinical impact of second-look endoscopy after endoscopic submucosal dissection of gastric neoplasms
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3404167/
https://www.ncbi.nlm.nih.gov/pubmed/22844558
http://dx.doi.org/10.5009/gnl.2012.6.3.316
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