Usefulness of endoscopic ultrasound for the prediction of intraoperative bleeding of endoscopic submucosal dissection for gastric neoplasms

Daisuke Kikuchi, Toshiro Iizuka, Shu Hoteya, Satoshi Yamashita, Masanori Nakamura, Yuichiro Kuroki, Toshihumi Mitani, Ai Fujimoto, Akira Matsui, Noriko Nishida, Naohisa Yahagi

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Background and Aim: Intraoperative bleeding is an important determining factor for the technical difficulty and safety of endoscopic submucosal dissection (ESD) for gastric neoplasms, which was previously difficult to predict before ESD. In the present study, we investigated whether endoscopic ultrasound (EUS) could be used to preoperatively predict intraoperative bleeding.Methods: The study included 106 patients who underwent EUS before ESD. EUS was used to evaluate the submucosal vascular structure. Patients who had at least 10 vascular structures per field of view or a vessel at least 500 μm in diameter were classified into the rich group (Group R), and others were classified into the non-rich group (Group N). The two groups were compared retrospectively with respect to procedure time, degree of anemia, frequency of clip use, and others.Results: There were 24 patients in Group R and 82 patients in Group N. Submucosal caner was found in 54.2% of patients in Group R and 18.3% in Group N. The reduction in hemoglobin was 5.8% in Group R and 3.45% in Group N. The procedure time was 151 min in Group R and 100 min in Group N. The frequency of clip use was 79.2% in Group R and 31.7% in Group N. A multivariate analysis revealed a significant difference in the depth of invasion and frequency of clip use between the two groups.Conclusions: The results suggest that identification of submucosal vascular structure by EUS might allow prediction of intraoperative bleeding during ESD.

Original languageEnglish
Pages (from-to)68-72
Number of pages5
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume26
Issue number1
DOIs
Publication statusPublished - 2011
Externally publishedYes

Fingerprint

Stomach Neoplasms
Hemorrhage
Surgical Instruments
Blood Vessels
Anemia
Hemoglobins
Multivariate Analysis
Endoscopic Mucosal Resection
Safety

Keywords

  • Endoscopic submucosal dissection
  • Gastric neoplasms
  • Intraoperative bleeding

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

Usefulness of endoscopic ultrasound for the prediction of intraoperative bleeding of endoscopic submucosal dissection for gastric neoplasms. / Kikuchi, Daisuke; Iizuka, Toshiro; Hoteya, Shu; Yamashita, Satoshi; Nakamura, Masanori; Kuroki, Yuichiro; Mitani, Toshihumi; Fujimoto, Ai; Matsui, Akira; Nishida, Noriko; Yahagi, Naohisa.

In: Journal of Gastroenterology and Hepatology (Australia), Vol. 26, No. 1, 2011, p. 68-72.

Research output: Contribution to journalArticle

Kikuchi, Daisuke ; Iizuka, Toshiro ; Hoteya, Shu ; Yamashita, Satoshi ; Nakamura, Masanori ; Kuroki, Yuichiro ; Mitani, Toshihumi ; Fujimoto, Ai ; Matsui, Akira ; Nishida, Noriko ; Yahagi, Naohisa. / Usefulness of endoscopic ultrasound for the prediction of intraoperative bleeding of endoscopic submucosal dissection for gastric neoplasms. In: Journal of Gastroenterology and Hepatology (Australia). 2011 ; Vol. 26, No. 1. pp. 68-72.
@article{91ca9d6a694f4c459420553757766395,
title = "Usefulness of endoscopic ultrasound for the prediction of intraoperative bleeding of endoscopic submucosal dissection for gastric neoplasms",
abstract = "Background and Aim: Intraoperative bleeding is an important determining factor for the technical difficulty and safety of endoscopic submucosal dissection (ESD) for gastric neoplasms, which was previously difficult to predict before ESD. In the present study, we investigated whether endoscopic ultrasound (EUS) could be used to preoperatively predict intraoperative bleeding.Methods: The study included 106 patients who underwent EUS before ESD. EUS was used to evaluate the submucosal vascular structure. Patients who had at least 10 vascular structures per field of view or a vessel at least 500 μm in diameter were classified into the rich group (Group R), and others were classified into the non-rich group (Group N). The two groups were compared retrospectively with respect to procedure time, degree of anemia, frequency of clip use, and others.Results: There were 24 patients in Group R and 82 patients in Group N. Submucosal caner was found in 54.2{\%} of patients in Group R and 18.3{\%} in Group N. The reduction in hemoglobin was 5.8{\%} in Group R and 3.45{\%} in Group N. The procedure time was 151 min in Group R and 100 min in Group N. The frequency of clip use was 79.2{\%} in Group R and 31.7{\%} in Group N. A multivariate analysis revealed a significant difference in the depth of invasion and frequency of clip use between the two groups.Conclusions: The results suggest that identification of submucosal vascular structure by EUS might allow prediction of intraoperative bleeding during ESD.",
keywords = "Endoscopic submucosal dissection, Gastric neoplasms, Intraoperative bleeding",
author = "Daisuke Kikuchi and Toshiro Iizuka and Shu Hoteya and Satoshi Yamashita and Masanori Nakamura and Yuichiro Kuroki and Toshihumi Mitani and Ai Fujimoto and Akira Matsui and Noriko Nishida and Naohisa Yahagi",
year = "2011",
doi = "10.1111/j.1440-1746.2010.06412.x",
language = "English",
volume = "26",
pages = "68--72",
journal = "Journal of Gastroenterology and Hepatology (Australia)",
issn = "0815-9319",
publisher = "Wiley-Blackwell",
number = "1",

}

TY - JOUR

T1 - Usefulness of endoscopic ultrasound for the prediction of intraoperative bleeding of endoscopic submucosal dissection for gastric neoplasms

AU - Kikuchi, Daisuke

AU - Iizuka, Toshiro

AU - Hoteya, Shu

AU - Yamashita, Satoshi

AU - Nakamura, Masanori

AU - Kuroki, Yuichiro

AU - Mitani, Toshihumi

AU - Fujimoto, Ai

AU - Matsui, Akira

AU - Nishida, Noriko

AU - Yahagi, Naohisa

PY - 2011

Y1 - 2011

N2 - Background and Aim: Intraoperative bleeding is an important determining factor for the technical difficulty and safety of endoscopic submucosal dissection (ESD) for gastric neoplasms, which was previously difficult to predict before ESD. In the present study, we investigated whether endoscopic ultrasound (EUS) could be used to preoperatively predict intraoperative bleeding.Methods: The study included 106 patients who underwent EUS before ESD. EUS was used to evaluate the submucosal vascular structure. Patients who had at least 10 vascular structures per field of view or a vessel at least 500 μm in diameter were classified into the rich group (Group R), and others were classified into the non-rich group (Group N). The two groups were compared retrospectively with respect to procedure time, degree of anemia, frequency of clip use, and others.Results: There were 24 patients in Group R and 82 patients in Group N. Submucosal caner was found in 54.2% of patients in Group R and 18.3% in Group N. The reduction in hemoglobin was 5.8% in Group R and 3.45% in Group N. The procedure time was 151 min in Group R and 100 min in Group N. The frequency of clip use was 79.2% in Group R and 31.7% in Group N. A multivariate analysis revealed a significant difference in the depth of invasion and frequency of clip use between the two groups.Conclusions: The results suggest that identification of submucosal vascular structure by EUS might allow prediction of intraoperative bleeding during ESD.

AB - Background and Aim: Intraoperative bleeding is an important determining factor for the technical difficulty and safety of endoscopic submucosal dissection (ESD) for gastric neoplasms, which was previously difficult to predict before ESD. In the present study, we investigated whether endoscopic ultrasound (EUS) could be used to preoperatively predict intraoperative bleeding.Methods: The study included 106 patients who underwent EUS before ESD. EUS was used to evaluate the submucosal vascular structure. Patients who had at least 10 vascular structures per field of view or a vessel at least 500 μm in diameter were classified into the rich group (Group R), and others were classified into the non-rich group (Group N). The two groups were compared retrospectively with respect to procedure time, degree of anemia, frequency of clip use, and others.Results: There were 24 patients in Group R and 82 patients in Group N. Submucosal caner was found in 54.2% of patients in Group R and 18.3% in Group N. The reduction in hemoglobin was 5.8% in Group R and 3.45% in Group N. The procedure time was 151 min in Group R and 100 min in Group N. The frequency of clip use was 79.2% in Group R and 31.7% in Group N. A multivariate analysis revealed a significant difference in the depth of invasion and frequency of clip use between the two groups.Conclusions: The results suggest that identification of submucosal vascular structure by EUS might allow prediction of intraoperative bleeding during ESD.

KW - Endoscopic submucosal dissection

KW - Gastric neoplasms

KW - Intraoperative bleeding

UR - http://www.scopus.com/inward/record.url?scp=78650356213&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=78650356213&partnerID=8YFLogxK

U2 - 10.1111/j.1440-1746.2010.06412.x

DO - 10.1111/j.1440-1746.2010.06412.x

M3 - Article

VL - 26

SP - 68

EP - 72

JO - Journal of Gastroenterology and Hepatology (Australia)

JF - Journal of Gastroenterology and Hepatology (Australia)

SN - 0815-9319

IS - 1

ER -