Second-look endoscopy and factors associated with delayed bleeding after endoscopic submucosal dissection.

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Oncology

Background:

• Endoscopic submucosal dissection (ESD) is a key curative treatment for early gastric cancer and superficial gastric neoplasms.
• Post-ESD bleeding remains a significant concern, occurring in approximately 5% of cases despite current preventative strategies.

Purpose of the Study:

• To evaluate the necessity and efficacy of second-look endoscopy (SLE) in preventing delayed bleeding after gastric ESD.
• To identify high-risk patient groups who may benefit from SLE.

Main Methods:

• Review of recent randomized studies and clinical practices regarding SLE after gastric ESD.
• Analysis of risk factors associated with delayed bleeding post-ESD.

Main Results:

• Recent evidence suggests routine SLE may not be necessary for all patients following gastric ESD.
• SLE can be a valuable tool for preventing delayed bleeding in selected high-risk patients.

Conclusions:

• Routine SLE is not universally recommended after gastric ESD.
• Identifying high-risk factors, such as large resected specimen size and concurrent antiplatelet therapy, is crucial for guiding SLE decisions.
• Further large-scale studies are needed to confirm SLE efficacy in high-risk populations.