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Carbazochrome sodium sulfonate is not effective for prevention of post-gastric endoscopic submucosal dissection bleeding: A retrospective study

BACKGROUND: Carbazochrome sodium sulfonate (CSS) is conventionally administered to prevent post-endoscopic submucosal dissection (ESD) bleeding in many institutions, but research on its preventive efficacy is lacking. Therefore, we investigated the risk of post-ESD bleeding and the preventive effica...

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Autores principales: Takahashi, Keitaro, Sasaki, Takahiro, Ueno, Nobuhiro, Uehara, Kyoko, Kobayashi, Yu, Sugiyama, Yuya, Murakami, Yuki, Kunogi, Takehito, Ando, Katsuyoshi, Kashima, Shin, Moriichi, Kentaro, Tanabe, Hiroki, Okumura, Toshikatsu, Fujiya, Mikihiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9485174/
https://www.ncbi.nlm.nih.gov/pubmed/35257213
http://dx.doi.org/10.1007/s00464-022-09171-4
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author Takahashi, Keitaro
Sasaki, Takahiro
Ueno, Nobuhiro
Uehara, Kyoko
Kobayashi, Yu
Sugiyama, Yuya
Murakami, Yuki
Kunogi, Takehito
Ando, Katsuyoshi
Kashima, Shin
Moriichi, Kentaro
Tanabe, Hiroki
Okumura, Toshikatsu
Fujiya, Mikihiro
author_facet Takahashi, Keitaro
Sasaki, Takahiro
Ueno, Nobuhiro
Uehara, Kyoko
Kobayashi, Yu
Sugiyama, Yuya
Murakami, Yuki
Kunogi, Takehito
Ando, Katsuyoshi
Kashima, Shin
Moriichi, Kentaro
Tanabe, Hiroki
Okumura, Toshikatsu
Fujiya, Mikihiro
author_sort Takahashi, Keitaro
collection PubMed
description BACKGROUND: Carbazochrome sodium sulfonate (CSS) is conventionally administered to prevent post-endoscopic submucosal dissection (ESD) bleeding in many institutions, but research on its preventive efficacy is lacking. Therefore, we investigated the risk of post-ESD bleeding and the preventive efficacy of CSS administration. METHODS: We retrospectively reviewed 304 lesions in 259 patients with gastric neoplasms who underwent ESD at Asahikawa Medical University Hospital from 2014 to 2021. In the CSS group, CSS 100 mg/day was intravenously infused with maintenance fluid replacement on postoperative days 0–2. The risk factors of post-ESD bleeding, including CSS administration, were investigated. RESULTS: The overall rate of post-ESD bleeding was 4.6% (14/304). The univariate analysis showed that atrial fibrillation (Af), warfarin intake, heparin replacement, and tumor location in the lower third were significant risk factors for increasing the likelihood of postoperative bleeding. In the multivariate analysis, Af (odds ratio [OR] 3.83, 95% CI 1.02–14.30; p < 0.05), heparin replacement (OR 4.60, 95% CI 1.02–20.70; p < 0.05), and tumor location in the lower third of the stomach (OR 6.67, 95% CI 1.43–31.00; p < 0.05) were independent factors for post-ESD bleeding. Post-ESD bleeding was observed in 5.2% (9/174) of the CSS group and 3.8% (5/130) of the non-CSS group, with no significant difference between the two groups (p = 0.783). Additionally, CSS was not shown to have preventive effects in groups with higher-risk factors, such as Af diagnosis, warfarin use, heparin replacement, and tumor location in the lower third of the stomach. CONCLUSION: CSS administration was not effective for the prevention of the post-ESD bleeding in the overall patient population as well as in higher-risk patients. This suggests that the administration of CSS for post-ESD bleeding prevention may need to be reconsidered.
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spelling pubmed-94851742022-09-21 Carbazochrome sodium sulfonate is not effective for prevention of post-gastric endoscopic submucosal dissection bleeding: A retrospective study Takahashi, Keitaro Sasaki, Takahiro Ueno, Nobuhiro Uehara, Kyoko Kobayashi, Yu Sugiyama, Yuya Murakami, Yuki Kunogi, Takehito Ando, Katsuyoshi Kashima, Shin Moriichi, Kentaro Tanabe, Hiroki Okumura, Toshikatsu Fujiya, Mikihiro Surg Endosc Article BACKGROUND: Carbazochrome sodium sulfonate (CSS) is conventionally administered to prevent post-endoscopic submucosal dissection (ESD) bleeding in many institutions, but research on its preventive efficacy is lacking. Therefore, we investigated the risk of post-ESD bleeding and the preventive efficacy of CSS administration. METHODS: We retrospectively reviewed 304 lesions in 259 patients with gastric neoplasms who underwent ESD at Asahikawa Medical University Hospital from 2014 to 2021. In the CSS group, CSS 100 mg/day was intravenously infused with maintenance fluid replacement on postoperative days 0–2. The risk factors of post-ESD bleeding, including CSS administration, were investigated. RESULTS: The overall rate of post-ESD bleeding was 4.6% (14/304). The univariate analysis showed that atrial fibrillation (Af), warfarin intake, heparin replacement, and tumor location in the lower third were significant risk factors for increasing the likelihood of postoperative bleeding. In the multivariate analysis, Af (odds ratio [OR] 3.83, 95% CI 1.02–14.30; p < 0.05), heparin replacement (OR 4.60, 95% CI 1.02–20.70; p < 0.05), and tumor location in the lower third of the stomach (OR 6.67, 95% CI 1.43–31.00; p < 0.05) were independent factors for post-ESD bleeding. Post-ESD bleeding was observed in 5.2% (9/174) of the CSS group and 3.8% (5/130) of the non-CSS group, with no significant difference between the two groups (p = 0.783). Additionally, CSS was not shown to have preventive effects in groups with higher-risk factors, such as Af diagnosis, warfarin use, heparin replacement, and tumor location in the lower third of the stomach. CONCLUSION: CSS administration was not effective for the prevention of the post-ESD bleeding in the overall patient population as well as in higher-risk patients. This suggests that the administration of CSS for post-ESD bleeding prevention may need to be reconsidered. Springer US 2022-03-07 2022 /pmc/articles/PMC9485174/ /pubmed/35257213 http://dx.doi.org/10.1007/s00464-022-09171-4 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Takahashi, Keitaro
Sasaki, Takahiro
Ueno, Nobuhiro
Uehara, Kyoko
Kobayashi, Yu
Sugiyama, Yuya
Murakami, Yuki
Kunogi, Takehito
Ando, Katsuyoshi
Kashima, Shin
Moriichi, Kentaro
Tanabe, Hiroki
Okumura, Toshikatsu
Fujiya, Mikihiro
Carbazochrome sodium sulfonate is not effective for prevention of post-gastric endoscopic submucosal dissection bleeding: A retrospective study
title Carbazochrome sodium sulfonate is not effective for prevention of post-gastric endoscopic submucosal dissection bleeding: A retrospective study
title_full Carbazochrome sodium sulfonate is not effective for prevention of post-gastric endoscopic submucosal dissection bleeding: A retrospective study
title_fullStr Carbazochrome sodium sulfonate is not effective for prevention of post-gastric endoscopic submucosal dissection bleeding: A retrospective study
title_full_unstemmed Carbazochrome sodium sulfonate is not effective for prevention of post-gastric endoscopic submucosal dissection bleeding: A retrospective study
title_short Carbazochrome sodium sulfonate is not effective for prevention of post-gastric endoscopic submucosal dissection bleeding: A retrospective study
title_sort carbazochrome sodium sulfonate is not effective for prevention of post-gastric endoscopic submucosal dissection bleeding: a retrospective study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9485174/
https://www.ncbi.nlm.nih.gov/pubmed/35257213
http://dx.doi.org/10.1007/s00464-022-09171-4
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