Related Experiment Video
Updated: May 12, 2026
Endoscopic Vacuum Therapy for the Treatment of Anastomotic Leakage after Total Gastrectomy with Esophagojejunostomy
Published on: August 22, 2025
Second-look endoscopy is not associated with better clinical outcomes after gastric endoscopic submucosal dissection:
Ho Yoel Ryu1, Jae Woo Kim, Hyun-Soo Kim
1Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
Background:
The efficacy of routine second-look endoscopy (SLE) to detect or prevent bleeding after gastric endoscopic submucosal dissection (ESD) has not yet been validated.
Objective:
The aim of this study was to determine whether SLE affects clinical outcomes including bleeding and morbidity after gastric ESD.
Design:
A prospective, randomized, controlled study with consecutive data analyzed on an as-treated basis.
Setting:
A single, tertiary-care referral center.
Patients:
A total of 182 patients.
Intervention:
Gastric ESD and SLE.
Main Outcome Measurements:
Incidence of and risk factors related to bleeding after ESD and outcomes by univariate or multivariate analysis.
Results:
Among 182 patients enrolled, 74 and 81 patients were assigned to the SLE and no-SLE groups, respectively. Two groups were observed closely for 4 weeks. Bleeding occurred after ESD in 21 patients (13.5%). Hemoglobin loss (≥2.0 g/dL) was observed in 20 patients, and melena developed in 1 patient after ESD. However, only 1 patient needed a transfusion. Twelve patients (16.2%) in the SLE group and 9 in the no-SLE group (11.1%) experienced bleeding after ESD. The frequency of bleeding after ESD was not significantly different between the 2 groups (P = .66). There were no risk factors related to bleeding after ESD.
Limitations:
Single-center analysis.
Conclusion:
SLE is not routinely necessary because it does not affect clinical outcomes, including bleeding and morbidity after ESD. (
Clinical Trial Registration Number:
KCT0000146.).
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