Related Experiment Video
Updated: Jun 18, 2026
Evaluation of the Effectiveness of Longitudinal Incision for Endoscopic Submucosal Excavation of Gastric Subepithelial Lesions
Published on: April 28, 2026
A second-look endoscopy after endoscopic submucosal dissection for gastric epithelial neoplasm may be unnecessary: a
Osamu Goto1, Mitsuhiro Fujishiro, Shinya Kodashima
1Department of Gastroenterology, The University of Tokyo, Tokyo, Japan.
Background:
Endoscopic submucosal dissection (ESD) is one of the curative endoluminal surgical procedures for gastric epithelial neoplasms. There has been little research on bleeding after gastric ESD.
Objective:
To investigate cases of post-ESD bleeding and to verify whether a second-look endoscopy after ESD is effective in the prevention of delayed bleeding.
Design:
A retrospective study with consecutive data.
Setting:
A single tertiary referral center.
Subjects:
A total of 454 gastric epithelial neoplasms (386 early gastric cancers and 68 gastric adenomas).
Interventions:
ESD and second-look endoscopy.
Main Outcome Measurements:
Predictors on post-ESD bleeding by univariate analysis, incidence of post-ESD bleedings, and the timing of those before and after second-look endoscopy.
Results:
Post-ESD bleeding occurred in 26 (5.7%) lesions. Gross type (flat or depressed type) was the only factor influencing post-ESD bleeding. All cases of post-ESD bleeding occurred within 14 days after ESD (median 2; range 0-14), and bleeding tended to occur from the lower and upper stomach earlier and later, respectively. In 19 lesions with delayed bleeding more than 24 hours after ESD, the maximum delayed bleeding rates before and after the second-look endoscopy were 2.8% and 2.5%, respectively.
Limitations:
A retrospective, single-center analysis.
Conclusions:
A second-look endoscopy after gastric ESD may contribute little to the prevention of delayed bleeding.
Related Concept Videos
01:29Endoscopic Procedures I: Esophagogastroduodenoscopy
During an EGD, the endoscope can be used to:
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
01:28Endoscopic Procedures III: Video Capsule Endoscopy
01:29Gastroesophageal Reflux Disease II: Clinical Features and Management
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
01:25Endoscopic Procedures II: Colonoscopy
01:28Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.