Predictors of immediate bleeding during endoscopic submucosal dissection in gastric lesions

Jeon, Seong Woo; Jung, Min Kyu; Cho, Chang Min; Tak, Won Young; Kweon, Young Oh; Kim, Sung Kook; Choi, Yong Hwan

doi:10.1007/s00464-008-9988-7

Cited by 88 publications

(80 citation statements)

References 19 publications

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“…It might be by reason that PPI was not fast acting, compared with more rapid effects of H 2 RA in reaching the optimal gastric pH [12,19]. Some studies reported bleeding and ulcer healing were associated with lesion size and tumor location [20,21], but it was difficult to stratify patients by these factors in our meta-analysis. Although Hp infection is generally accepted as a causal factor in the pathogenesis of peptic ulcer, a few studies revealed Hp status did not affect ulcer healing after ESD [22,23].…”

Section: Discussionmentioning

confidence: 66%

Proton Pump Inhibitors versus Histamine-2-Receptor Antagonists for the Management of Iatrogenic Gastric Ulcer after Endoscopic Mucosal Resection or Endoscopic Submucosal Dissection: A Meta-Analysis of Randomized Trials

Yang

Liu

et al. 2011

Digestion

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Background/Aims: Both proton pump inhibitor (PPI) and histamine-2-receptor antagonist (H₂RA) are considered to be effective for the treatment of iatrogenic gastric ulcer after endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD). We aimed to systematically evaluate the evidence comparing PPI and H₂RA for iatrogenic ulcer. Methods: Data from PubMed, Cochrane Library and Google Scholar were searched to identify eligible randomized trials. Outcome measures were delayed bleeding, epigastric pain and ulcer healing. Results: Six full-text studies were identified including a total of 522 patients. Pooled data suggested a significantly lower bleeding rate in the PPI group than in the H₂RA group (odds ratio (OR) 0.49, 95% confidence interval (CI) 0.25-0.95). Subgroup analysis showed PPI was more effective in the prevention of bleeding than H₂RA for ESD-induced ulcer (OR 0.41, 95% CI 0.20-0.85) and 8-week duration of medication (OR 0.36, 95% CI 0.17-0.76). There were no differences in the incidence of epigastric pain (OR 0.90, 95% CI 0.53-1.51) and ulcer healing rate after endoscopic therapies between both groups. Conclusion: This meta-analysis shows PPI is superior to H₂RA for the prevention of delayed bleeding without different effectiveness in the reduction of epigastric pain and in the promotion of ulcer healing after EMR or ESD.

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Section: Discussionmentioning

confidence: 66%

Proton Pump Inhibitors versus Histamine-2-Receptor Antagonists for the Management of Iatrogenic Gastric Ulcer after Endoscopic Mucosal Resection or Endoscopic Submucosal Dissection: A Meta-Analysis of Randomized Trials

Yang

Liu

et al. 2011

Digestion

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“…22,26,27 Gotoda 28 demonstrated that the tumors located in the upper or middle third of the stomach, and those with ulcer were prone to perforate after ESD. In the present study, multivariate analysis failed to reveal a significant risk factor associated with post-ESD bleeding.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Endoscopic Submucosal Dissection for Early Gastric Cancer in Patients with Comorbid Diseases

Kim

Chang²,

Kim

et al. 2010

Gut Liver

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“…Oda et al reported that only location (upper and middle third) and size (≥ 31 mm) were associated with immediate bleeding [8] . In one report, younger age and the location of the lesions (upper and middle third) were associated with a higher frequency of immediate bleeding [9] . Bleeding can be somewhat reduced in areas with abundant blood vessels by strengthening the coagulation energy when precutting or dissection, but this increases the risk of perforation.…”

Section: Hemorrhagementioning

confidence: 99%

Management of complications following endoscopic submucosal dissection for gastric cancer

Kim

Park²

2011

WJGE

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Endoscopic treatment should be considered for early gas tric cancer (EGC) and gastric precancerous lesions. Endo scopic submucosal dissection (ESD) was developed for en bloc removal of a large gastric neoplasm and has been developed following improvements in electrical equip ment for hemostasis and dissection and with advances in various knives, hemostatic forceps and endoscopic equipment. ESD is currently the treatment of choice for precancerous lesions or EGC showing mucosal invasion. Hemorrhage and perforation are major complications of ESD for EGC. We describe the complication of ESD pro cedures in gastric lesions for endoscopists who are rela tively inexperienced in ESD and who may lack optimal access to ESD education and facilities.

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Predictors of immediate bleeding during endoscopic submucosal dissection in gastric lesions

Abstract: The results of this study demonstrated that age and lesion location were related to the ESD procedure outcome.

Cited by 88 publications

References 19 publications

Proton Pump Inhibitors versus Histamine-2-Receptor Antagonists for the Management of Iatrogenic Gastric Ulcer after Endoscopic Mucosal Resection or Endoscopic Submucosal Dissection: A Meta-Analysis of Randomized Trials

Proton Pump Inhibitors versus Histamine-2-Receptor Antagonists for the Management of Iatrogenic Gastric Ulcer after Endoscopic Mucosal Resection or Endoscopic Submucosal Dissection: A Meta-Analysis of Randomized Trials

Efficacy and Safety of Endoscopic Submucosal Dissection for Early Gastric Cancer in Patients with Comorbid Diseases

Management of complications following endoscopic submucosal dissection for gastric cancer

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