Risk factors for bleeding after endoscopic submucosal dissection for gastric lesions

Tsuji, Yosuke; Ohata, Ken; Ito, Takafumi; Chiba, Hideyuki; Ohya, Tomohiko R.; Gunji, Toshiaki; Matsuhashi, Nobuyuki

doi:10.3748/wjg.v16.i23.2913

Cited by 105 publications

(102 citation statements)

References 11 publications

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“…34 Furthermore, 10 studies found no significant differences in elderly patients, 19,25,30,[35][36][37][38][39][40][41] although 1 study identified age > 80 years as an independent risk factor for PPB. 42 PPB rates were similar between genders in most studies, [13][14][15][16][17][18][20][21][22][23][25][26][27][28][29][30][31][32][33][34]36,39,[42][43][44] with only 1 study reporting an association male sex associated with PPB. 24 Arterial hypertension was not identified as a risk factor in most studies, [13][14][15]17,18,[20][21][22][23][24][28]…”

Section: Risk Factors For Ppbmentioning

confidence: 73%

“…42 PPB rates were similar between genders in most studies, [13][14][15][16][17][18][20][21][22][23][25][26][27][28][29][30][31][32][33][34]36,39,[42][43][44] with only 1 study reporting an association male sex associated with PPB. 24 Arterial hypertension was not identified as a risk factor in most studies, [13][14][15]17,18,[20][21][22][23][24][28][29][30][31]33,42,43,45 although 2 studies reported significantly higher PPB rates in hypertensive patients. 16,36 However, the adjusted OR was .67 in the latter study.…”

Section: Risk Factors For Ppbmentioning

confidence: 73%

“…36 Similarly, diabetes mellitus was not identified as a significant risk factor in any study. [13][14][15][16][17][18][20][21][22][23][24][28][29][30][31]33,34,36,42,44,45 Cardiopathy (ischemic heart disease in most studies), 10 were not identified as risk factors for PPB in most studies. Chronic kidney disease was not identified as a risk factor in some studies despite a trend to higher bleeding.…”

Section: Risk Factors For Ppbmentioning

confidence: 95%

“…When the studies evaluated the mean sizes of tumors and resected specimens between those with PPB and those without, the results were conflicting, with some reporting significant differences between tumor 22,26,34,42 and specimen 21,23,24,29,34,42 sizes and others not finding significant differences between the 2 groups. 13,14,[16][17][18]20,27,28,[31][32][33]51 In addition, results concerning whether tumor location impacts PPB were controversial. Four studies reported that tumors located in the lower third 33,34,36,57 and in the middle/lower third 27,31,37,38 of the stomach had significantly higher bleeding rates, whereas the upper location of the stomach was found to be a significant risk factor in other studies.…”

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confidence: 99%

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Risk factors for bleeding after gastric endoscopic submucosal dissection: a systematic review and meta-analysis

Libânio

Costa

Pimentel‐Nunes

et al. 2016

Gastrointestinal Endoscopy

117

127

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Section: Risk Factors For Ppbmentioning

confidence: 73%

Section: Risk Factors For Ppbmentioning

confidence: 73%

Section: Risk Factors For Ppbmentioning

confidence: 95%

mentioning

confidence: 99%

See 2 more Smart Citations

Risk factors for bleeding after gastric endoscopic submucosal dissection: a systematic review and meta-analysis

Libânio

Costa

Pimentel‐Nunes

et al. 2016

Gastrointestinal Endoscopy

117

127

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“…In patients for whom the resection was determined to be curative, there was no evidence of local recurrence or distant metastasis during a mean (±SD) observation period of 39.2 ± 25.8 months (range 5.8-91.2 months) in the case of early sESD and 33.3 ± 30.1 months (range 11.9-80.6 months) in the case of late sESD. [25,26]. Here, we analyzed more cases over a longer observation period compared with previous studies, and the total local recurrence rate was 0.4 % (8/2042).…”

Section: Resultsmentioning

confidence: 90%

Secondary endoscopic submucosal dissection for residual or recurrent tumors after gastric endoscopic submucosal dissection

et al. 2013

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Background Endoscopic submucosal dissection (ESD) is a widely accepted technique for the management of gastric tumors. However, residual or recurrent tumors can occur after ESD; currently, there is no adequate management strategy for these tumors. Thus, the aim of the present study was to establish a strategy of secondary ESD (sESD) for cases with positive lateral margins (LM?), which cause post-ESD residual or recurrent tumors. Methods Fifty-three lesions that were subjected to ESD were diagnosed as LM? with suspected local residual tumor. The short-and long-term outcomes of early sESD (performed shortly after the initial ESD in LM? cases to prevent local recurrence) were retrospectively compared with those of late sESD (performed after the detection of recurrent tumors). Results Of the 53 LM? cases, the local residual positive rate was 38.5 % (10/26) in those undergoing early sESD or additional surgery and the local recurrence rate was 29.6 % (8/27) in those that were not treated. Thus, the overall incidence of residual or recurrent tumors in LM? cases was 34.0 % (18/53). Both early and late sESD had favorable outcomes with no severe complications: 100 % of early sESD resections were curative, compared with 86.7 % of late sESD resections, over the course of a mean (±SD) observation period of 50.8 ± 16.7 months. The performance of early sESD was significantly greater than that of late sESD (in terms of dissection speed). Conclusions Early sESD is more reliable than late sESD as a therapeutic strategy for salvaging residual tumors and for preventing recurrence. However, if a tumor has already recurred, late sESD remains useful.

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Risk factors for perforation during colorectal endoscopic submucosal dissection

Yang

Hung

Chen

2022

Adv in Digestive Medicine

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Endoscopic submucosal dissection (ESD) achieves higher en bloc resection rates than endoscopic mucosal resection in early colorectal neoplasms. However, perforation occurs more frequently during ESD. We aimed to identify the risk factors for perforation during colorectal ESD. A total of 161 patients treated with colorectal ESD at a tertiary center between January 2014 and December 2019 were enrolled in this retrospective study. Perforation was defined as a deep defect of the muscularis propria, with or without direct contact with connective tissue outside the colon. Clinical risk factors for perforation during ESD, including age, sex, tumor morphology, tumor size, tumor location, procedure time, en bloc resection rate, histology, and submucosal fibrosis, were analyzed. The mean size of the ESD specimens was 38.2 ± 24.6 mm. The overall en bloc resection rate was 98.1%. Perforations occurred during ESD in 31 out of 161 patients (19.3%). All perforations were successfully treated with endoscopic closure using the hemoclips and nonsurgical management. Emergency surgery was not required in our patients. On multivariate analysis, severe submucosal fibrosis (odds ratio [OR] 3.06; 95% confidence interval [CI] 1.23‐7.59; P = .016) and location in the right colon (OR 4.54; 95% CI 1.31‐15.79; P = .017) were independent risk factors. Perforation during colorectal ESD occurred in 31 patients (19.3%), but all patients had a good outcome without surgery. Submucosal fibrosis and its location are risk factors for perforation during ESD.

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Risk factors for bleeding after endoscopic submucosal dissection for gastric lesions

Abstract: Beginner coagulators, tumor in the antrum, and medicines were significant risk factors for post-ESD bleeding. Bleeding at the ulcer margin frequently occurred with beginner operators.

Cited by 105 publications

References 11 publications

Risk factors for bleeding after gastric endoscopic submucosal dissection: a systematic review and meta-analysis

Risk factors for bleeding after gastric endoscopic submucosal dissection: a systematic review and meta-analysis

Secondary endoscopic submucosal dissection for residual or recurrent tumors after gastric endoscopic submucosal dissection

Risk factors for perforation during colorectal endoscopic submucosal dissection

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