Influencing factors of postoperative bleeding in endoscopic submucosal dissection and endoscopic mucosal resection for early gastric cancer
10.3760/cma.j.issn.1007-5232.2019.08.003
- VernacularTitle:内镜黏膜下剥离术和内镜黏膜切除术治疗早期胃癌的术后出血影响因素分析
- Author:
Si LIU
1
;
Qian ZHANG
;
Jie XING
;
Xiujing SUN
;
Min ZHU
;
Junfeng GUO
;
Shengtao ZHU
;
Peng LI
;
Shutian ZHANG
Author Information
1. 首都医科大学附属北京友谊医院消化内科 国家消化系统疾病临床医学研究中心北京市消化疾病中心 首都医科大学消化病学系 消化疾病癌前病变北京市重点实验室 100050
- Keywords:
Endoscopic mucosal resection;
Risk factors;
Endoscopic submucosal dissection;
Early gastric cancer;
Postoperative bleeding
- From:
Chinese Journal of Digestive Endoscopy
2019;36(8):552-557
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the possible influencing factors of postoperative bleeding after endoscopic submucosal dissection and endoscopic mucosal resection ( ESD/EMR) for early gastric cancer. Methods Clinical data of patients receiving ESD/EMR for the diagnosis of early gastric cancer at the Endoscopy Center of Beijing Friendship Hospital from January 2013 to May 2018, including demographic information ( age, gender and history ) , endoscopic lesion characteristics ( tumor size, location and morphology) and postoperative pathological features ( differentiated types and invasive depth) were collected to analyze the effects of these factors on bleeding after ESD/EMR. Results A total of 195 patients with early gastric cancer were included in the study and 9 cases ( 4. 6％) had postoperative bleeding. The medication history of clopidogrel and main lesion sizes were statistically different between postoperative bleeding group and non-bleeding group ( P=0. 018 and P=0. 034 ) . Multivariate analysis showed a history of clopidogrel ( OR=10. 223, 95％CI:1. 143-91. 468, P= 0. 038 ) , multiple lesions ( OR= 6. 412, 95％CI:1. 123-36. 616, P=0. 037) and lesions sizes of larger than 2 cm ( OR=6. 718, 95％CI:1. 130-39. 935, P=0. 036) were possible risk factors for postoperative bleeding. Survival analysis showed of higher postoperative bleeding risks in patients with the history of clopidogrel ( P<0. 001) and lesions sizes of more than 2 cm ( P=0. 022) . Conclusion More attention should be paid to the risk of ESD/EMR postoperative bleeding in early gastric cancer patients with medication history of clopidogrel and multiple large lesions.
