The Myth and Truth about the Usefulness of Second-Look Endoscopy Following Endoscopic Submucosal Resection

Kim, Hye Kang; Cheung, Dae Young

doi:10.5009/gnl14265

Cited by 2 publications

(2 citation statements)

References 13 publications

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“…It was similar with our study and previous studies about factors related to delayed bleeding following ESD. 21 The present study supported the Kim et al . 20 result.…”

Section: Discussionsupporting

confidence: 92%

Is a Second-Look Endoscopy Necessary after Endoscopic Submucosal Dissection for Gastric Neoplasm?

Kim

Kang

et al. 2015

Gut Liver

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Background/AimsSecond-look endoscopy is performed to check for the possibility of post-endoscopic submucosal dissection (ESD) bleeding and to perform prophylactic hemostasis in most hospitals; however, there is little evidence about the efficacy of second-look endoscopy. We investigated whether second-look endoscopy after ESD is useful in the prevention of post-ESD bleeding.MethodsA total of 550 lesions with gastric epithelial neoplasms in 502 patients (372 men and 130 women) were treated with ESD between August 18, 2009 and August 18, 2010. After the exclusion of three lesions of post-ESD bleeding within 24 hours, 547 lesions (335 early gastric cancers and 212 gastric adenomas) were included for the final analysis.ResultsThe occurrence rate of delayed post-ESD bleeding was not significantly different between the second-look group and the no second-look group (1% vs 2.5%, p>0.05). The only predictor of delayed bleeding was tumor size, regardless of second-look endoscopy after ESD (22.8±9.87 vs 15.1±10.47, p<0.05). There was no difference between the prophylactic hemostasis and nonprophylactic hemostasis groups, including the occurrence rate of delayed bleeding. In the second-look group with prophylactic hemostasis, the hospital stay was more prolonged than in the second-look group without prophylactic hemostasis, but there was no significant difference (p=0.08).ConclusionsSecond-look endoscopy to prevent delayed bleeding after ESD provides no significant medical benefits.

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“…It was similar with our study and previous studies about factors related to delayed bleeding following ESD. 21 The present study supported the Kim et al . 20 result.…”

Section: Discussionsupporting

confidence: 92%

Is a Second-Look Endoscopy Necessary after Endoscopic Submucosal Dissection for Gastric Neoplasm?

Kim

Kang

et al. 2015

Gut Liver

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“… 11 , 12 However, the role of a routine post-ESD second-look endoscopy in cases with no signs of bleeding has not been fully characterized. 13 , 14 Therefore, we conducted a study to evaluate whether performing a post-ESD second-look endoscopy before patients were discharged could reduce the risk of delayed post-ESD bleeding.…”

Section: Introductionmentioning

confidence: 99%

Second-Look Endoscopy after Gastric Endoscopic Submucosal Dissection for Reducing Delayed Postoperative Bleeding

Park¹,

Park²,

Lee³

et al. 2015

Gut Liver

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Background/AimsThis stuy evaluated the role of a second-look endoscopy after gastric endoscopic submucosal dissection in patients without signs of bleeding.MethodsBetween March 2011 and March 2012, 407 patients with gastric neoplasms who underwent endoscopic submucosal dissection for 445 lesions were retrospectively reviewed. After the patients had undergone endoscopic submucosal dissection, they were allocated to two groups (with or without second-look endoscopy) according to the following endoscopy. The postoperative bleeding risk of the lesions was not considered when allocating the patients.ResultsThe delayed postoperative bleeding rates did not differ between the two groups (with vs without second-look endoscopy, 3.0% vs 2.1%; p=0.546). However, a tumor in the upper-third of the stomach (odds ratio [OR], 5.353; 95% confidence interval [CI], 1.075 to 26.650) and specimen size greater than 40 mm (OR, 4.794; 95% CI, 1.307 to 17.588) were both independent risk factors for delayed postoperative bleeding. Additionally, second-look endoscopy was not related to reduced delayed postoperative bleeding. However, delayed postoperative bleeding in the patients who did not undergo a second-look endoscopy occurred significantly earlier than that in patients who underwent a second-look endoscopy (4.5 and 14.0 days, respectively, p=0.022).ConclusionsA routine second-look endoscopy after gastric endoscopic submucosal dissection is not necessary for all patients.

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The Myth and Truth about the Usefulness of Second-Look Endoscopy Following Endoscopic Submucosal Resection

Cited by 2 publications

References 13 publications

Is a Second-Look Endoscopy Necessary after Endoscopic Submucosal Dissection for Gastric Neoplasm?

Is a Second-Look Endoscopy Necessary after Endoscopic Submucosal Dissection for Gastric Neoplasm?

Second-Look Endoscopy after Gastric Endoscopic Submucosal Dissection for Reducing Delayed Postoperative Bleeding

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