AI Article Synopsis
- The study examined the risk factors for post-ESD bleeding (after endoscopic submucosal dissection) in 1,767 lesions from patients with early gastric cancer.
- Acute bleeding occurred in 129 cases (7.3%), while delayed bleeding occurred in 21 cases (1.2%), with different risk factors identified for each type.
- Key risk factors included lesion size of ≥40 mm and the use of multiple antithrombotic medications, highlighting that both types of bleeding have distinct clinical characteristics.
Article Abstract
Background/aims: Few studies have classified risk factors according to the onset time of bleeding after endoscopic submucosal dissection (post-ESD bleeding).
Methods: We studied 1767 consecutive lesions in patients who underwent ESD for early gastric cancer from December 2006 through June 2016. Patients who had a remnant stomach or who had undergone reconstruction with a gastric tube were excluded. Post-ESD bleeding was classified into acute bleeding (0-5 days after ESD) and delayed bleeding (6 or more days after ESD), and the risk factors for each type of bleeding were compared.
Results: Post-ESD bleeding occurred in 150 (8.5%) of 1767 lesions. Bleeding was acute in 129 lesions (7.3%) and delayed in 21 (1.2%). Acute post-ESD bleeding was frequently associated with lesions located in the distal stomach, expanded indications or non-indicated lesions, a specimen diameter of ≥40 mm, and antithrombotic therapy. Delayed post-ESD bleeding was often associated with lesions located in the proximal stomach, hemodialysis, and antithrombotic therapy. Among 334 lesions in patients who received antithrombotic therapy, post-ESD bleeding occurred in 47 lesions (14.1%). Independent risk factors for post-ESD bleeding were a specimen diameter of ≥40 mm and treatment with 2 or more antithrombotic agents.
Conclusions: Acute post-ESD bleeding and delayed post-ESD bleeding were associated with different clinical characteristics. Antithrombotic therapy is a risk factor for post-ESD bleeding in both the acute and delayed phases.
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| http://dx.doi.org/10.1007/s00464-017-5513-1 | DOI Listing |
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