A second-look endoscopy may not reduce the bleeding after endoscopic submucosal dissection for gastric epithelial neoplasm
Gastric endoscopic submucosal dissection (ESD) has gradually come to be recommended as the optimal treatment for early gastric cancer; however, one of the primary issues is postoperative bleeding. Although second-look endoscopy is conventionally performed to reduce the risk of postoperative bleeding...
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| Veröffentlicht in: | BMC gastroenterology 2014-08, Vol.14 (1), p.152-152, Article 9004 |
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| creator | Takahashi, Fumiaki Yoshitake, Naoto Akima, Takashi Kino, Hitoshi Nakano, Masakazu Tsuchida, Chieko Tsuchida, Kohei Tominaga, Keiichi Sasai, Takako Masuyama, Hironori Hiraishi, Hideyuki |
| description | Gastric endoscopic submucosal dissection (ESD) has gradually come to be recommended as the optimal treatment for early gastric cancer; however, one of the primary issues is postoperative bleeding. Although second-look endoscopy is conventionally performed to reduce the risk of postoperative bleeding, its benefit has not yet been clearly elucidated. The objective of this study was to elucidate the benefit of second-look endoscopy.
A total of 459 lesions in patients were underwent gastric ESD from May 2004 to April 2013 at our hospital were included in the analysis. The patients were divided into those who had bleeding within 24 hours after ESD (immediate bleeding) and those in whom bleeding occurred 24 hours or more after the procedure (delayed bleeding); the underlying disease, age, lesion site, diameter of the resected specimen, and lesion diameter were analyzed to identify the risk factors for postoperative bleeding after ESD.
Post-ESD immediate or delayed bleeding occurred in 23 of the 459 cases (5.0%). Second-look endoscopy was performed in 210 of 447 cases (47.0%) excluding 12 cases with immediate bleeding; in the remaining 237 of the 447 cases (53.0%), it was not performed. Post-ESD delayed bleeding occurred in 6 of the 210 cases (2.9%) and 5 of the 237 cases (2.1%), with no statistically significant difference between the two groups. Overall, the following factors were identified as the risk factors for postoperative bleeding: young age (P = 0.005), lesions in the L segment (P = 0.042), and large size of the resected specimen (P = 0.005). The risk factors identified in the immediate bleeding group were lesions in the L segment (P = 0.032), large size of the resected specimen (P < 0.001), and large tumor size (P = 0.011), and those in the delayed bleeding group were young age (P = 0.013) and concomitant renal disease (P = 0.011).
The results of this study suggest that second-look endoscopy after gastric ESD may not be useful for preventing postoperative bleeding. |
| doi_str_mv | 10.1186/1471-230X-14-152 |
| format | Article |
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A total of 459 lesions in patients were underwent gastric ESD from May 2004 to April 2013 at our hospital were included in the analysis. The patients were divided into those who had bleeding within 24 hours after ESD (immediate bleeding) and those in whom bleeding occurred 24 hours or more after the procedure (delayed bleeding); the underlying disease, age, lesion site, diameter of the resected specimen, and lesion diameter were analyzed to identify the risk factors for postoperative bleeding after ESD.
Post-ESD immediate or delayed bleeding occurred in 23 of the 459 cases (5.0%). Second-look endoscopy was performed in 210 of 447 cases (47.0%) excluding 12 cases with immediate bleeding; in the remaining 237 of the 447 cases (53.0%), it was not performed. Post-ESD delayed bleeding occurred in 6 of the 210 cases (2.9%) and 5 of the 237 cases (2.1%), with no statistically significant difference between the two groups. Overall, the following factors were identified as the risk factors for postoperative bleeding: young age (P = 0.005), lesions in the L segment (P = 0.042), and large size of the resected specimen (P = 0.005). The risk factors identified in the immediate bleeding group were lesions in the L segment (P = 0.032), large size of the resected specimen (P < 0.001), and large tumor size (P = 0.011), and those in the delayed bleeding group were young age (P = 0.013) and concomitant renal disease (P = 0.011).
The results of this study suggest that second-look endoscopy after gastric ESD may not be useful for preventing postoperative bleeding.</description><identifier>ISSN: 1471-230X</identifier><identifier>EISSN: 1471-230X</identifier><identifier>DOI: 10.1186/1471-230X-14-152</identifier><identifier>PMID: 25148855</identifier><language>eng</language><publisher>England: BioMed Central</publisher><subject>Adenocarcinoma - pathology ; Adenocarcinoma - surgery ; Age Factors ; Aged ; Dissection ; Epithelium - pathology ; Epithelium - surgery ; Female ; Gastroenterology ; Gastroscopy ; Humans ; Male ; Postoperative Hemorrhage - prevention & control ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms - pathology ; Stomach Neoplasms - surgery</subject><ispartof>BMC gastroenterology, 2014-08, Vol.14 (1), p.152-152, Article 9004</ispartof><rights>2014 Takahashi et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.</rights><rights>Copyright © 2014 Takahashi et al.; licensee BioMed Central Ltd. 2014 Takahashi et al.; licensee BioMed Central Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b554t-5ded92cc989d850708f1754cd4a40f3682fe0708a9dbaf03b4e8d7e11a0d4703</citedby><cites>FETCH-LOGICAL-b554t-5ded92cc989d850708f1754cd4a40f3682fe0708a9dbaf03b4e8d7e11a0d4703</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4304014/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4304014/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,27903,27904,53769,53771</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25148855$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Takahashi, Fumiaki</creatorcontrib><creatorcontrib>Yoshitake, Naoto</creatorcontrib><creatorcontrib>Akima, Takashi</creatorcontrib><creatorcontrib>Kino, Hitoshi</creatorcontrib><creatorcontrib>Nakano, Masakazu</creatorcontrib><creatorcontrib>Tsuchida, Chieko</creatorcontrib><creatorcontrib>Tsuchida, Kohei</creatorcontrib><creatorcontrib>Tominaga, Keiichi</creatorcontrib><creatorcontrib>Sasai, Takako</creatorcontrib><creatorcontrib>Masuyama, Hironori</creatorcontrib><creatorcontrib>Hiraishi, Hideyuki</creatorcontrib><title>A second-look endoscopy may not reduce the bleeding after endoscopic submucosal dissection for gastric epithelial neoplasm</title><title>BMC gastroenterology</title><addtitle>BMC Gastroenterol</addtitle><description>Gastric endoscopic submucosal dissection (ESD) has gradually come to be recommended as the optimal treatment for early gastric cancer; however, one of the primary issues is postoperative bleeding. Although second-look endoscopy is conventionally performed to reduce the risk of postoperative bleeding, its benefit has not yet been clearly elucidated. The objective of this study was to elucidate the benefit of second-look endoscopy.
A total of 459 lesions in patients were underwent gastric ESD from May 2004 to April 2013 at our hospital were included in the analysis. The patients were divided into those who had bleeding within 24 hours after ESD (immediate bleeding) and those in whom bleeding occurred 24 hours or more after the procedure (delayed bleeding); the underlying disease, age, lesion site, diameter of the resected specimen, and lesion diameter were analyzed to identify the risk factors for postoperative bleeding after ESD.
Post-ESD immediate or delayed bleeding occurred in 23 of the 459 cases (5.0%). Second-look endoscopy was performed in 210 of 447 cases (47.0%) excluding 12 cases with immediate bleeding; in the remaining 237 of the 447 cases (53.0%), it was not performed. Post-ESD delayed bleeding occurred in 6 of the 210 cases (2.9%) and 5 of the 237 cases (2.1%), with no statistically significant difference between the two groups. Overall, the following factors were identified as the risk factors for postoperative bleeding: young age (P = 0.005), lesions in the L segment (P = 0.042), and large size of the resected specimen (P = 0.005). The risk factors identified in the immediate bleeding group were lesions in the L segment (P = 0.032), large size of the resected specimen (P < 0.001), and large tumor size (P = 0.011), and those in the delayed bleeding group were young age (P = 0.013) and concomitant renal disease (P = 0.011).
The results of this study suggest that second-look endoscopy after gastric ESD may not be useful for preventing postoperative bleeding.</description><subject>Adenocarcinoma - pathology</subject><subject>Adenocarcinoma - surgery</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Dissection</subject><subject>Epithelium - pathology</subject><subject>Epithelium - surgery</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Gastroscopy</subject><subject>Humans</subject><subject>Male</subject><subject>Postoperative Hemorrhage - prevention & control</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Stomach Neoplasms - pathology</subject><subject>Stomach Neoplasms - surgery</subject><issn>1471-230X</issn><issn>1471-230X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNp1ks1r3DAQxUVpadK0956KoJde3Eq2ZGsvhbD0CwK55JCbkKXxRqmscSW7sP3rK7PJkpTmpGHmp8fjzRDylrOPnKv2Excdr-qGXVdcVFzWz8jpsfX8QX1CXuV8yxjvVN28JCe15EIpKU_Jn3OawWJ0VUD8SSE6zBanPR3NnkacaQK3WKDzDdA-ADgfd9QMM6Qj6y3NSz8uFrMJ1PlcBGePkQ6Y6M7kORUCJl8kgi9EBJyCyeNr8mIwIcObu_eMXH39crX9Xl1cfvuxPb-oeinFXEkHblNbu1EbpyTrmBp4J4V1wgg2NK2qB1i7ZuN6M7CmF6BcB5wb5kTHmjPy-SA7FZPgLMQ5maCn5EeT9hqN148n0d_oHf7WomGCcVEEtgeB3uMTAo8nFke9Rq_X6Euly2aKyoc7Gwl_LZBnPfpsIQRT8liy5m1ds7ZR3Yq-_we9xSXFktFKcSWUbNtCsQNlE-acYDg64kyv1_E_D-8eRnH8cH8OzV-nObj1</recordid><startdate>20140823</startdate><enddate>20140823</enddate><creator>Takahashi, Fumiaki</creator><creator>Yoshitake, Naoto</creator><creator>Akima, Takashi</creator><creator>Kino, Hitoshi</creator><creator>Nakano, Masakazu</creator><creator>Tsuchida, Chieko</creator><creator>Tsuchida, Kohei</creator><creator>Tominaga, Keiichi</creator><creator>Sasai, Takako</creator><creator>Masuyama, Hironori</creator><creator>Hiraishi, Hideyuki</creator><general>BioMed Central</general><general>BioMed Central Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7QR</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20140823</creationdate><title>A second-look endoscopy may not reduce the bleeding after endoscopic submucosal dissection for gastric epithelial neoplasm</title><author>Takahashi, Fumiaki ; Yoshitake, Naoto ; Akima, Takashi ; Kino, Hitoshi ; Nakano, Masakazu ; Tsuchida, Chieko ; Tsuchida, Kohei ; Tominaga, Keiichi ; Sasai, Takako ; Masuyama, Hironori ; Hiraishi, Hideyuki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b554t-5ded92cc989d850708f1754cd4a40f3682fe0708a9dbaf03b4e8d7e11a0d4703</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adenocarcinoma - pathology</topic><topic>Adenocarcinoma - surgery</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Dissection</topic><topic>Epithelium - pathology</topic><topic>Epithelium - surgery</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Gastroscopy</topic><topic>Humans</topic><topic>Male</topic><topic>Postoperative Hemorrhage - prevention & control</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Stomach Neoplasms - pathology</topic><topic>Stomach Neoplasms - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Takahashi, Fumiaki</creatorcontrib><creatorcontrib>Yoshitake, Naoto</creatorcontrib><creatorcontrib>Akima, Takashi</creatorcontrib><creatorcontrib>Kino, Hitoshi</creatorcontrib><creatorcontrib>Nakano, Masakazu</creatorcontrib><creatorcontrib>Tsuchida, Chieko</creatorcontrib><creatorcontrib>Tsuchida, Kohei</creatorcontrib><creatorcontrib>Tominaga, Keiichi</creatorcontrib><creatorcontrib>Sasai, Takako</creatorcontrib><creatorcontrib>Masuyama, Hironori</creatorcontrib><creatorcontrib>Hiraishi, Hideyuki</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Chemoreception Abstracts</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMC gastroenterology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Takahashi, Fumiaki</au><au>Yoshitake, Naoto</au><au>Akima, Takashi</au><au>Kino, Hitoshi</au><au>Nakano, Masakazu</au><au>Tsuchida, Chieko</au><au>Tsuchida, Kohei</au><au>Tominaga, Keiichi</au><au>Sasai, Takako</au><au>Masuyama, Hironori</au><au>Hiraishi, Hideyuki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A second-look endoscopy may not reduce the bleeding after endoscopic submucosal dissection for gastric epithelial neoplasm</atitle><jtitle>BMC gastroenterology</jtitle><addtitle>BMC Gastroenterol</addtitle><date>2014-08-23</date><risdate>2014</risdate><volume>14</volume><issue>1</issue><spage>152</spage><epage>152</epage><pages>152-152</pages><artnum>9004</artnum><issn>1471-230X</issn><eissn>1471-230X</eissn><abstract>Gastric endoscopic submucosal dissection (ESD) has gradually come to be recommended as the optimal treatment for early gastric cancer; however, one of the primary issues is postoperative bleeding. Although second-look endoscopy is conventionally performed to reduce the risk of postoperative bleeding, its benefit has not yet been clearly elucidated. The objective of this study was to elucidate the benefit of second-look endoscopy.
A total of 459 lesions in patients were underwent gastric ESD from May 2004 to April 2013 at our hospital were included in the analysis. The patients were divided into those who had bleeding within 24 hours after ESD (immediate bleeding) and those in whom bleeding occurred 24 hours or more after the procedure (delayed bleeding); the underlying disease, age, lesion site, diameter of the resected specimen, and lesion diameter were analyzed to identify the risk factors for postoperative bleeding after ESD.
Post-ESD immediate or delayed bleeding occurred in 23 of the 459 cases (5.0%). Second-look endoscopy was performed in 210 of 447 cases (47.0%) excluding 12 cases with immediate bleeding; in the remaining 237 of the 447 cases (53.0%), it was not performed. Post-ESD delayed bleeding occurred in 6 of the 210 cases (2.9%) and 5 of the 237 cases (2.1%), with no statistically significant difference between the two groups. Overall, the following factors were identified as the risk factors for postoperative bleeding: young age (P = 0.005), lesions in the L segment (P = 0.042), and large size of the resected specimen (P = 0.005). The risk factors identified in the immediate bleeding group were lesions in the L segment (P = 0.032), large size of the resected specimen (P < 0.001), and large tumor size (P = 0.011), and those in the delayed bleeding group were young age (P = 0.013) and concomitant renal disease (P = 0.011).
The results of this study suggest that second-look endoscopy after gastric ESD may not be useful for preventing postoperative bleeding.</abstract><cop>England</cop><pub>BioMed Central</pub><pmid>25148855</pmid><doi>10.1186/1471-230X-14-152</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Springer Nature OA Free Journals; Springer Nature - Complete Springer Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Adenocarcinoma - pathology Adenocarcinoma - surgery Age Factors Aged Dissection Epithelium - pathology Epithelium - surgery Female Gastroenterology Gastroscopy Humans Male Postoperative Hemorrhage - prevention & control Retrospective Studies Risk Factors Stomach Neoplasms - pathology Stomach Neoplasms - surgery |
| title | A second-look endoscopy may not reduce the bleeding after endoscopic submucosal dissection for gastric epithelial neoplasm |
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