Incidence of Delayed Bleeding among Patients Continuing Antithrombotics during Gastric Endoscopic Submucosal Dissection

OBJECTIVE: In patients continuing antithrombotics, delayed bleeding after gastric endoscopic submucosal dissection (ESD) is a severe complication. Vonoprazan (VPZ) exerts a rapid, potent, and long-lasting antacid effect compared with traditional proton-pump inhibitors (PPIs). This study aimed to com...

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Autores principales: Kakushima, Naomi, Ono, Hiroyuki, Takizawa, Kohei, Tanaka, Masaki, Kawata, Noboru, Yoshida, Masao, Murai, Katsuyuki, Yabuuchi, Yohei, Kishida, Yoshihiro, Ito, Sayo, Imai, Kenichiro, Hotta, Kinichi, Ishiwatari, Hirotoshi, Matsubayashi, Hiroyuki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society of Internal Medicine 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6815908/
https://www.ncbi.nlm.nih.gov/pubmed/31582592
http://dx.doi.org/10.2169/internalmedicine.2754-19
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author Kakushima, Naomi
Ono, Hiroyuki
Takizawa, Kohei
Tanaka, Masaki
Kawata, Noboru
Yoshida, Masao
Murai, Katsuyuki
Yabuuchi, Yohei
Kishida, Yoshihiro
Ito, Sayo
Imai, Kenichiro
Hotta, Kinichi
Ishiwatari, Hirotoshi
Matsubayashi, Hiroyuki
author_facet Kakushima, Naomi
Ono, Hiroyuki
Takizawa, Kohei
Tanaka, Masaki
Kawata, Noboru
Yoshida, Masao
Murai, Katsuyuki
Yabuuchi, Yohei
Kishida, Yoshihiro
Ito, Sayo
Imai, Kenichiro
Hotta, Kinichi
Ishiwatari, Hirotoshi
Matsubayashi, Hiroyuki
author_sort Kakushima, Naomi
collection PubMed
description OBJECTIVE: In patients continuing antithrombotics, delayed bleeding after gastric endoscopic submucosal dissection (ESD) is a severe complication. Vonoprazan (VPZ) exerts a rapid, potent, and long-lasting antacid effect compared with traditional proton-pump inhibitors (PPIs). This study aimed to compare the incidence of delayed bleeding after gastric ESD between the use of VPZ and PPIs in patients continuing antithrombotics. METHODS: In this retrospective analysis, we examined 71 patients with 101 lesions treated with traditional PPIs (PPI group) and 59 patients with 90 lesions treated with VPZ (VPZ group). After 2 days (day 0 and 1) of intravenous PPI administration, either an oral PPI or VPZ was administered from postoperative day 2 to 8 weeks after ESD. We assessed the incidence of overall delayed bleeding as well as bleeding that occurred from day 2 until 8 weeks after ESD. RESULTS: There was no significant difference in the use of antithrombotic agents between the groups. Overall delayed bleeding occurred 13 times (18%) in 9 patients in the PPI group and 18 times (31%) in 17 patients in the VPZ group (p=0.10). Bleeding from day 2 until 8 weeks after ESD occurred 12 times (17%) in 9 patients in the PPI group and 8 times (14%) in 8 patients in the VPZ group. CONCLUSION: Even with a potent antacid agent, such as VPZ, the incidence of delayed bleeding was high in patients undergoing ESD with continuous antithrombotic agents.
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spelling pubmed-68159082019-10-29 Incidence of Delayed Bleeding among Patients Continuing Antithrombotics during Gastric Endoscopic Submucosal Dissection Kakushima, Naomi Ono, Hiroyuki Takizawa, Kohei Tanaka, Masaki Kawata, Noboru Yoshida, Masao Murai, Katsuyuki Yabuuchi, Yohei Kishida, Yoshihiro Ito, Sayo Imai, Kenichiro Hotta, Kinichi Ishiwatari, Hirotoshi Matsubayashi, Hiroyuki Intern Med Original Article OBJECTIVE: In patients continuing antithrombotics, delayed bleeding after gastric endoscopic submucosal dissection (ESD) is a severe complication. Vonoprazan (VPZ) exerts a rapid, potent, and long-lasting antacid effect compared with traditional proton-pump inhibitors (PPIs). This study aimed to compare the incidence of delayed bleeding after gastric ESD between the use of VPZ and PPIs in patients continuing antithrombotics. METHODS: In this retrospective analysis, we examined 71 patients with 101 lesions treated with traditional PPIs (PPI group) and 59 patients with 90 lesions treated with VPZ (VPZ group). After 2 days (day 0 and 1) of intravenous PPI administration, either an oral PPI or VPZ was administered from postoperative day 2 to 8 weeks after ESD. We assessed the incidence of overall delayed bleeding as well as bleeding that occurred from day 2 until 8 weeks after ESD. RESULTS: There was no significant difference in the use of antithrombotic agents between the groups. Overall delayed bleeding occurred 13 times (18%) in 9 patients in the PPI group and 18 times (31%) in 17 patients in the VPZ group (p=0.10). Bleeding from day 2 until 8 weeks after ESD occurred 12 times (17%) in 9 patients in the PPI group and 8 times (14%) in 8 patients in the VPZ group. CONCLUSION: Even with a potent antacid agent, such as VPZ, the incidence of delayed bleeding was high in patients undergoing ESD with continuous antithrombotic agents. The Japanese Society of Internal Medicine 2019-10-01 /pmc/articles/PMC6815908/ /pubmed/31582592 http://dx.doi.org/10.2169/internalmedicine.2754-19 Text en Copyright © 2019 by The Japanese Society of Internal Medicine https://creativecommons.org/licenses/by-nc-nd/4.0/ The Internal Medicine is an Open Access journal distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Kakushima, Naomi
Ono, Hiroyuki
Takizawa, Kohei
Tanaka, Masaki
Kawata, Noboru
Yoshida, Masao
Murai, Katsuyuki
Yabuuchi, Yohei
Kishida, Yoshihiro
Ito, Sayo
Imai, Kenichiro
Hotta, Kinichi
Ishiwatari, Hirotoshi
Matsubayashi, Hiroyuki
Incidence of Delayed Bleeding among Patients Continuing Antithrombotics during Gastric Endoscopic Submucosal Dissection
title Incidence of Delayed Bleeding among Patients Continuing Antithrombotics during Gastric Endoscopic Submucosal Dissection
title_full Incidence of Delayed Bleeding among Patients Continuing Antithrombotics during Gastric Endoscopic Submucosal Dissection
title_fullStr Incidence of Delayed Bleeding among Patients Continuing Antithrombotics during Gastric Endoscopic Submucosal Dissection
title_full_unstemmed Incidence of Delayed Bleeding among Patients Continuing Antithrombotics during Gastric Endoscopic Submucosal Dissection
title_short Incidence of Delayed Bleeding among Patients Continuing Antithrombotics during Gastric Endoscopic Submucosal Dissection
title_sort incidence of delayed bleeding among patients continuing antithrombotics during gastric endoscopic submucosal dissection
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6815908/
https://www.ncbi.nlm.nih.gov/pubmed/31582592
http://dx.doi.org/10.2169/internalmedicine.2754-19
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