A Multicenter Survey of the Management After Gastric Endoscopic Submucosal Dissection Related to Postoperative Bleeding

Goto, Osamu; Fujishiro, Mitsuhiro; Oda, Ichiro; Kakushima, Naomi; Yamamoto, Yorimasa; Tsuji, Yosuke; Ohata, Ken; Fujiwara, Takashi; Fujiwara, Junko; Ishii, Naoki; Yokoi, Chizu; Miyamoto, Shin’ichi; Itoh, Toshiyuki; Morishita, Shinji; Gotoda, Takuji; Koike, Kazuhiko

doi:10.1007/s10620-011-1886-5

Cited by 89 publications

(81 citation statements)

References 18 publications

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“…after second-look endoscopy were not significantly different (4,5). In our study, however, more delayed bleedings occurred before second-look endoscopy than after (p=0,022).…”

Section: Discussioncontrasting

confidence: 61%

“…Most hospitals routinely perform a second-look endoscopy to check for delayed bleeding, though there is little solid evidence to support this practice. Two reports have suggested that a second-look endoscopy after gastric ESD does not contribute significantly in the prevention of delayed bleeding (4,5). However, this has been held true in our experience.…”

Section: Introductioncontrasting

confidence: 47%

“…Two retrospective studies have suggested that second-look endoscopy to prevent delayed bleeding might be excessive or unnecessary (4,5). The frequencies of delayed bleeding between before and F Fi ig gu ur re e 2 2. .…”

Section: Discussionmentioning

confidence: 99%

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The role of second-look endoscopy in endoscopic submucosal dissection for early gastric cancer

Kim

Kim²,

Kim³

et al. 2013

Turk J Gastroenterol

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“…after second-look endoscopy were not significantly different (4,5). In our study, however, more delayed bleedings occurred before second-look endoscopy than after (p=0,022).…”

Section: Discussioncontrasting

confidence: 61%

Section: Introductioncontrasting

confidence: 47%

See 1 more Smart Citation

The role of second-look endoscopy in endoscopic submucosal dissection for early gastric cancer

Kim

Kim²,

Kim³

et al. 2013

Turk J Gastroenterol

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show abstract

“…Antithrombotic drugs and low-dose aspirin were discontinued in all patients who resumed oral ingestion following endoscopic hemostasis, and there were no deaths or complications due to withdrawal. Recent reports in Japan, including the present study, have shown that endoscopic hemostasis is the first indication for bleeding ulcers (37)(38)(39)(40)(41). The rate of hemostasis has been reported to be >95% in Japan, resulting in decreased mortality rates and indications for surgical treatment (42)(43)(44)(45).…”

Section: Discussionmentioning

confidence: 51%

Low-dose Aspirin and Comorbidities are Significantly Related to Bleeding Peptic Ulcers in Elderly Patients Compared with Nonelderly Patients in Japan

et al. 2014

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Objective The present study was conducted using data accumulated from our earlier study of bleeding peptic ulcers, focusing on elderly patients. Methods A total of 461 patients with bleeding peptic ulcers underwent emergency endoscopy at Saga Medical School Hospital between 1999 and 2011. Risk factors for bleeding peptic ulcers were compared between two groups: an elderly group (! 65 years old) and a nonelderly group (<65 years old). The relationship between drug use and age was examined using multiple logistic regression models. In the elderly group, the factors were compared between Period I (1999Period I ( -2005 and Period II (2006II ( -2011. Results The proportion of men and the incidence of Helicobacter pylori infection were lower in the elderly group than in the nonelderly group. The use of low-dose aspirin, antithrombotic drugs and corticosteroids, but not nonsteroidal anti-inflammatory drugs, was higher in the elderly group. A multiple logistic regression analysis of prescribed medications indicated that low-dose aspirin was more frequently used in the elderly group. The rate of comorbidities was higher and the hemoglobin levels were lower in the elderly group. The rates of rebleeding within one week and death within one month did not differ in the elderly group. Compared with that observed in Period I, the incidence of Helicobacter pylori infection was decreased and the rate of comorbidities was increased in Period II. Conclusion This study indicates that factors related to bleeding peptic ulcers in elderly patients have shifted from Helicobacter pylori infection to comorbidities associated with low-dose aspirin, suggesting a close relationship between low-dose aspirin therapy and comorbidities in elderly patients with peptic ulcers.

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“…ESD has been accepted as a minimally invasive method for local resection for EGC with a negligible risk of lymph node metastasis [3] (Table 1). Although ESD is much less invasive than conventional open gastrectomy, complications have been reported to include hemorrhage in 5.5% of patients and delayed perforation in 0.45% [10,11].…”

Section: Minimally Invasive Treatment Methods For Early Gastric Cancermentioning

confidence: 99%

Recent Advances in Endoscopic and Laparoscopic Management of Gastric Malignancy: A Literature Review

Kawahira¹,

Hayashi²,

Asano³

et al. 2013

J Gastrointest Dig Syst

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The current gold standard treatment for early gastric cancer (EGC) is en bloc resection with D2 lymph node dissection because GC tends to spread to the lymph nodes at an early stage. Endoscopic submucosal dissection (ESD) and laparoscopic gastrectomy may be considered as treatment options for EGC, depending on oncological stage. ESD provide local treatment only. Sentinel node (SN) mapping can indicate which nodes will be the first to be affected. Local resection of the primary lesion with SN biopsy would therefore be an ideal treatment for EGC. ESD followed by SN biopsy involve full-thickness resection of the gastric wall, and it is expected that they will be more commonly used for the treatment of appropriate stages of EGC in the near future.

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A Multicenter Survey of the Management After Gastric Endoscopic Submucosal Dissection Related to Postoperative Bleeding

Abstract: Post-ESD management (duration of PPI use, resumption of food intake, and performance of second-look endoscopy) varied among the medical centers; thus, randomized controlled trials are required for an optimal strategy after gastric ESD.

Cited by 89 publications

References 18 publications

The role of second-look endoscopy in endoscopic submucosal dissection for early gastric cancer

The role of second-look endoscopy in endoscopic submucosal dissection for early gastric cancer

Low-dose Aspirin and Comorbidities are Significantly Related to Bleeding Peptic Ulcers in Elderly Patients Compared with Nonelderly Patients in Japan

Recent Advances in Endoscopic and Laparoscopic Management of Gastric Malignancy: A Literature Review

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