Prophylactic effect of compression stockings for elevated D‐dimer levels following endoscopic submucosal dissection

Abstract

ObjectivesA relationship between endoscopic submucosal dissection (ESD) and deep vein thrombosis has been recognized. We previously reported that a high corrected midazolam dose (total midazolam dose/initial dose of midazolam used to induce sedation) is related to elevated D‐dimer levels after ESD. In this study, the effect of compression stockings (CSs) in preventing thrombosis following ESD under sedation was evaluated by measuring D‐dimer levels before and after ESD.MethodsThe participants were patients who underwent ESD for upper gastrointestinal tumors during the period between April 2018 and October 2022. Patients with pre‐ESD D‐dimer levels ≥1.6 µg/m and patients with corrected midazolam doses ≤3.0 were excluded. A retrospective investigation of the relationship between CS use and high post‐ESD D‐dimer levels (difference in D‐dimer levels ≥1.0 µg/mL between before and after ESD) was conducted.ResultsThere were 27 patients in the non‐CS group (NCS) and 33 patients in the CS group. The number of patients with high post‐ESD D‐dimer levels was 13 (48.2%) in the non‐CS group and six (18.2%) in the CS group; the number in the CS group was significantly lower (p = 0.024). On logistic regression analysis, a relationship was seen between the wearing of CSs and a lower number of patients with high post‐ESD D‐dimer levels (odds ratio 0.24, 95% confidence interval 0.08–0.79, p = 0.019).ConclusionWearing CSs was related to a lower risk of high post‐ESD D‐dimer levels. This result suggests that thrombus formation is a cause of elevated D‐dimer levels after ESD.