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Bleeding Risk Factors after Endoscopic Submucosal Dissection in Early Gastric Cancer and the Necessity of “Second-Look” Endoscopic Examination on the following Day

Background and Aim: Hemorrhage is often encountered after endoscopic submucosal dissection (ESD). In addition to active bleeding after resection, exposed blood vessels and blood clots without active bleeding on the post-dissection ulcer floor have been recognized within our department. We consider e...

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Autores principales: Kobayashi, Rika, Kawaura, Ken, Ito, Tohru, Azukisawa, Sadafumi, Kunou, Hiroaki, Kamai, Junji, Hamada, Kazu, Mukai, Tsuyoshi, Kitakata, Hidekazu, Ishigaki, Yasuhito
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8876973/
https://www.ncbi.nlm.nih.gov/pubmed/35207187
http://dx.doi.org/10.3390/jcm11040914
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author Kobayashi, Rika
Kawaura, Ken
Ito, Tohru
Azukisawa, Sadafumi
Kunou, Hiroaki
Kamai, Junji
Hamada, Kazu
Mukai, Tsuyoshi
Kitakata, Hidekazu
Ishigaki, Yasuhito
author_facet Kobayashi, Rika
Kawaura, Ken
Ito, Tohru
Azukisawa, Sadafumi
Kunou, Hiroaki
Kamai, Junji
Hamada, Kazu
Mukai, Tsuyoshi
Kitakata, Hidekazu
Ishigaki, Yasuhito
author_sort Kobayashi, Rika
collection PubMed
description Background and Aim: Hemorrhage is often encountered after endoscopic submucosal dissection (ESD). In addition to active bleeding after resection, exposed blood vessels and blood clots without active bleeding on the post-dissection ulcer floor have been recognized within our department. We consider exposed and/or observable vessel findings and clots on the ulcer floor after re-section as important risk factors for hemorrhage. Here, we compared and examined the active bleeding frequency and “post-resection ulcer at risk of bleeding” on the day following ESD, in relation to their risk factors. Method: We retrospectively examined 447 patients who underwent second-look endoscopy in our department between August 2008 and March 2018. Logistic regression analyses were performed to determine the hazard ratio and 95% confidence interval. We compared the association of each factor mentioned above with active bleeding on the day after ESD and the presence of ulcers at risk of bleeding after resection. Results: Our retrospective analysis revealed that the risk factors were larger ulcer sizes and the administration of antithrombotic drugs. Additionally, the risk was low for upper body lesions but high for antral lesions. Conclusion: Our results may help determine whether second-look endoscopy should be performed to minimize active bleeding after ESD, reduce postoperative complications, and improve medical safety.
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spelling pubmed-88769732022-02-26 Bleeding Risk Factors after Endoscopic Submucosal Dissection in Early Gastric Cancer and the Necessity of “Second-Look” Endoscopic Examination on the following Day Kobayashi, Rika Kawaura, Ken Ito, Tohru Azukisawa, Sadafumi Kunou, Hiroaki Kamai, Junji Hamada, Kazu Mukai, Tsuyoshi Kitakata, Hidekazu Ishigaki, Yasuhito J Clin Med Article Background and Aim: Hemorrhage is often encountered after endoscopic submucosal dissection (ESD). In addition to active bleeding after resection, exposed blood vessels and blood clots without active bleeding on the post-dissection ulcer floor have been recognized within our department. We consider exposed and/or observable vessel findings and clots on the ulcer floor after re-section as important risk factors for hemorrhage. Here, we compared and examined the active bleeding frequency and “post-resection ulcer at risk of bleeding” on the day following ESD, in relation to their risk factors. Method: We retrospectively examined 447 patients who underwent second-look endoscopy in our department between August 2008 and March 2018. Logistic regression analyses were performed to determine the hazard ratio and 95% confidence interval. We compared the association of each factor mentioned above with active bleeding on the day after ESD and the presence of ulcers at risk of bleeding after resection. Results: Our retrospective analysis revealed that the risk factors were larger ulcer sizes and the administration of antithrombotic drugs. Additionally, the risk was low for upper body lesions but high for antral lesions. Conclusion: Our results may help determine whether second-look endoscopy should be performed to minimize active bleeding after ESD, reduce postoperative complications, and improve medical safety. MDPI 2022-02-09 /pmc/articles/PMC8876973/ /pubmed/35207187 http://dx.doi.org/10.3390/jcm11040914 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kobayashi, Rika
Kawaura, Ken
Ito, Tohru
Azukisawa, Sadafumi
Kunou, Hiroaki
Kamai, Junji
Hamada, Kazu
Mukai, Tsuyoshi
Kitakata, Hidekazu
Ishigaki, Yasuhito
Bleeding Risk Factors after Endoscopic Submucosal Dissection in Early Gastric Cancer and the Necessity of “Second-Look” Endoscopic Examination on the following Day
title Bleeding Risk Factors after Endoscopic Submucosal Dissection in Early Gastric Cancer and the Necessity of “Second-Look” Endoscopic Examination on the following Day
title_full Bleeding Risk Factors after Endoscopic Submucosal Dissection in Early Gastric Cancer and the Necessity of “Second-Look” Endoscopic Examination on the following Day
title_fullStr Bleeding Risk Factors after Endoscopic Submucosal Dissection in Early Gastric Cancer and the Necessity of “Second-Look” Endoscopic Examination on the following Day
title_full_unstemmed Bleeding Risk Factors after Endoscopic Submucosal Dissection in Early Gastric Cancer and the Necessity of “Second-Look” Endoscopic Examination on the following Day
title_short Bleeding Risk Factors after Endoscopic Submucosal Dissection in Early Gastric Cancer and the Necessity of “Second-Look” Endoscopic Examination on the following Day
title_sort bleeding risk factors after endoscopic submucosal dissection in early gastric cancer and the necessity of “second-look” endoscopic examination on the following day
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8876973/
https://www.ncbi.nlm.nih.gov/pubmed/35207187
http://dx.doi.org/10.3390/jcm11040914
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