Risk factors for bleeding after endoscopic submucosal dissection of gastric mucosal lesions
10.3760/cma.j.issn.1007-5232.2012.02.002
- VernacularTitle:内镜下胃黏膜剥离术后出血的相关危险因素分析
- Author:
Xiuxue FENG
;
Enqiang LINHU
;
Zhongsheng LU
;
Xiangdong WANG
;
Jiangyun MENG
;
Hongbin WANG
;
Hong DU
- Publication Type:Journal Article
- Keywords:
Bleeding;
Risk factors;
Endoscopic submucosal dissection
- From:
Chinese Journal of Digestive Endoscopy
2012;29(2):65-68
- CountryChina
- Language:Chinese
-
Abstract:
Objective To determine the incidence and clinical factors associated with bleeding after endoscopic submucosal dissection (ESD) of gastric mucosal lesions.Methods Clinical,endoscopic and pathological data of 223 lesions in 215 ESD patients between January 2009 and October 2011 were collected.The following factors associated with bleeding were analyzed:( 1 ) patient-related factors:sex,age,concomitant diseases including hypertension and diabetes mellitus,history of administration of anticoagulants or antiplatelet agents; (2) lesion-related factors:size,location,ulcer or scar findings,macroscopic types and pathological types; (3) procedure-related factors:en-bloc resection,spray of porcine fibrin sealant and operation time. Results Thirteen patients (13 lesions ) developed bleeding after ESD,among whom 7(53.8％) occurred within 24 hours after the procedure,5 (38.5％) within 1 week and 1 (7.7％) on the sixteenth day after ESD.Univariate and multivariate analysis revealed that lesion size ( ≥5 cm; odds ratio 8.663 ; 95％ CI:2.081 - 36.075) was an independent risk factor for bleeding.Conclusion Lesion size is the independent risk factor for bleeding after ESD,so careful preparation and close monitoring are required during and after ESD.In the meantime efforts should be made to identify and exactly demarcate lesions to minimize the size of resected specimens and reduce the risk of bleeding after ESD.
