Endoscopic submucosal dissection for early gastric cancer without interruption of warfarin and aspirin.

Many guidelines for the management of antithrombotic therapy in endoscopic procedures state that warfarin should be replaced by heparin in high risk endoscopic procedures. However, heparin bridging therapy is costly, requires a long hospital stay, and is indicated as a risk factor for bleeding after endoscopic submucosal dissection (ESD). It is not yet clear whether it is better to perform gastric ESD on continuous warfarin therapy or heparin bridging therapy.

Continuous aspirin use does not increase post-endoscopic dissection bleeding risk for gastric neoplasms in patients on antiplatelet therapy.

Background And Study Aims: Discontinuation of all antiplatelet agents before endoscopic procedures may cause serious complications in some patients. The aim of this study was to evaluate the hemorrhagic risk of post-endoscopic submucosal dissection (ESD) in patients on antiplatelet therapy (APT).

Patients And Methods: The subjects were 350 patients (377 lesions) who underwent gastric ESD between January 2007 and July 2013.

[A case of huge omental-origin liposarcoma controlled by a combination of ifosfamide and adriamycin].

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