A second-look endoscopy after endoscopic submucosal dissection for gastric epithelial neoplasm may be unnecessary: a retrospective analysis of postendoscopic submucosal dissection bleeding

Osamu Goto, Mitsuhiro Fujishiro, Shinya Kodashima, Satoshi Ono, Keiko Niimi, Kousuke Hirano, Nobutake Yamamichi, Kazuhiko Koike

研究成果: Article査読

88 被引用数 (Scopus)

抄録

Background: Endoscopic submucosal dissection (ESD) is one of the curative endoluminal surgical procedures for gastric epithelial neoplasms. There has been little research on bleeding after gastric ESD. Objective: To investigate cases of post-ESD bleeding and to verify whether a second-look endoscopy after ESD is effective in the prevention of delayed bleeding. Design: A retrospective study with consecutive data. Setting: A single tertiary referral center. Subjects: A total of 454 gastric epithelial neoplasms (386 early gastric cancers and 68 gastric adenomas). Interventions: ESD and second-look endoscopy. Main Outcome Measurements: Predictors on post-ESD bleeding by univariate analysis, incidence of post-ESD bleedings, and the timing of those before and after second-look endoscopy. Results: Post-ESD bleeding occurred in 26 (5.7%) lesions. Gross type (flat or depressed type) was the only factor influencing post-ESD bleeding. All cases of post-ESD bleeding occurred within 14 days after ESD (median 2; range 0-14), and bleeding tended to occur from the lower and upper stomach earlier and later, respectively. In 19 lesions with delayed bleeding more than 24 hours after ESD, the maximum delayed bleeding rates before and after the second-look endoscopy were 2.8% and 2.5%, respectively. Limitations: A retrospective, single-center analysis. Conclusions: A second-look endoscopy after gastric ESD may contribute little to the prevention of delayed bleeding.

本文言語English
ページ(範囲)241-248
ページ数8
ジャーナルGastrointestinal Endoscopy
71
2
DOI
出版ステータスPublished - 2010 2月

ASJC Scopus subject areas

  • 放射線学、核医学およびイメージング
  • 消化器病学

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