Clinical outcomes of second-look endoscopy after gastric endoscopic submucosal dissection: predictive factors with high risks of bleeding View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2014-02-26

AUTHORS

Cheol Woong Choi, Hyung Wook Kim, Dae Hwan Kang, Yong Mi Hong, Su Jin Kim, Su Bum Park, Mong Cho, Dong Jun Kim, Joung Boom Hong

ABSTRACT

BackgroundA second-look endoscopy is routinely performed after endoscopic submucosal dissection (ESD) in many institutions, although the need is questionable. Additional hemostatic procedures might be necessary for the post-ESD ulcer with a high risk of bleeding. We investigated the predictive factors for post-ESD ulcers with a high risk of bleeding. MethodsSecond-look endoscopy was performed on the day following ESD. The post-ESD ulcers were categorized into two risk groups according to the Forrest classification: high-risk ulcer stigma (type I and IIa) and low-risk ulcer stigma. We analyzed the risk factors associated with high-risk ulcer stigma and late delayed bleeding. ResultsDuring the study period, 616 ESD procedures were performed. Second-look endoscopy revealed that the incidence of high-risk ulcer stigma post-ESD was 15.1 %. Early and late delayed bleeding rates were 3.7 and 1.9 %, respectively. Multivariate analysis revealed that submucosal fibrosis and nausea were significantly related to high-risk ulcer stigma after ESD. Multivariate analysis revealed that surface erosion, location of the lesion, and high-risk ulcer stigma identified by second-look endoscopy were significantly associated with late delayed bleeding.ConclusionsThe effective use of selective second-look endoscopy will help limit unnecessary procedures. Submucosal fibrosis and nausea were risk factors associated with high-risk ulcer stigma after ESD. More... »

PAGES

2213-2220

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00464-014-3457-2

DOI

http://dx.doi.org/10.1007/s00464-014-3457-2

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1026811320

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/24570014


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