Risk factors for delayed bleeding by onset time after endoscopic submucosal dissection for gastric neoplasm

Scientific Reports
Hyeong Seok NamDae Gon Ryu

Abstract

Post-endoscopic submucosal dissection bleeding (PEB) is one of the important complications after endoscopic submucosal dissection (ESD), but still difficult to predict. The present study aimed to identify significant risk factors for PEB according to onset time. Between November 2008 and January 2016, a total of 1864 lesions resected via ESD were analyzed. PEB was classified as either early or late according to onset time (within or after 24 hours post-ESD, respectively). During second-look endoscopy, the artificial ulcer bed was subjected to Forrest classification. A high risk of stigma was defined as active spurting bleeding, oozing bleeding, and a non-bleeding visible vessel in the ulcer. The endoscopic factors and medications associated with PEB were analyzed. PEB occurred in 77 lesions (4.1%): early only in 46 (2.4%), late only in 22 (1.1%), and early and late in 9 (0.4%). Among 55 early PEB events, 25 were asymptomatic and diagnosed during second-look endoscopy. Age ≤65 years, resection size ≥30 mm, procedure time ≥20 min, lower third of the stomach, erosion, and clopidogrel use were significantly associated with early PEB. If the number of risk factors were ≤1, the risk of early PEB was 0.6%. For late PEB, the mid to upp...Continue Reading

References

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Jun 28, 2016·Gastrointestinal Endoscopy·Diogo LibânioMário Dinis-Ribeiro

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Citations

Dec 18, 2019·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Jai Hoon YoonHang Lak Lee
Aug 28, 2020·World Journal of Gastrointestinal Endoscopy·Marcello MaidaEmanuele Sinagra
Feb 13, 2020·Journal of Digestive Diseases·Chao Hu YangRui Hua Shi
Dec 4, 2020·World Journal of Gastrointestinal Endoscopy·Andrew ChanRajvinder Singh
Mar 2, 2021·Journal of Gastroenterology and Hepatology·Yeon Hwa ChoeYong Chan Lee
Feb 5, 2021·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Minami HashimotoHiromasa Ohira
Oct 14, 2021·Clinical and Translational Gastroenterology·Mitsushige SugimotoTakashi Kawai

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Methods Mentioned

BETA
dissection
biopsy

Software Mentioned

Statistical Package for the Social Sciences ( SPSS )

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