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Bleeding after endoscopic submucosal dissection: Risk factors and preventive methods.

Yosuke Kataoka1, Yosuke Tsuji1, Yoshiki Sakaguchi1

  • 1Yosuke Kataoka, Yosuke Tsuji, Yoshiki Sakaguchi, Chihiro Minatsuki, Itsuko Asada-Hirayama, Keiko Niimi, Satoshi Ono, Shinya Kodashima, Nobutake Yamamichi, Mitsuhiro Fujishiro, Kazuhiko Koike, Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan.

World Journal of Gastroenterology
|July 29, 2016
PubMed
Summary

Endoscopic submucosal dissection (ESD) offers effective gastrointestinal neoplasm treatment but carries bleeding risks. This review overviews risk factors and prevention methods for post-ESD bleeding, crucial for endoscopists.

Keywords:
Antithrombotic agentsBleedingEndoscopic submucosal dissectionPreventionRisk factor

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Area of Science:

  • Gastroenterology
  • Endoscopic Surgery

Background:

  • Endoscopic submucosal dissection (ESD) is a standard treatment for superficial gastrointestinal neoplasms, enabling en bloc resection and accurate histological assessment.
  • While advantageous over endoscopic mucosal resection (EMR) for lesion removal, ESD presents higher risks of perioperative adverse events, notably bleeding.

Purpose of the Study:

  • To review and overview risk factors associated with post-ESD bleeding.
  • To summarize methods for preventing bleeding after endoscopic submucosal dissection.
  • To highlight the need for endoscopist knowledge of these factors and preventive strategies.

Main Methods:

  • Review of previous studies on post-ESD bleeding.
  • Analysis of risk factors for bleeding after endoscopic submucosal dissection.
  • Evaluation of preventive strategies for post-ESD bleeding.

Main Results:

  • Bleeding is the most frequent adverse event following ESD, potentially leading to severe complications.
  • Preventive measures, including medication and hemostasis, do not completely eliminate the risk of post-ESD bleeding.
  • Increasing numbers of high-risk cases, such as those on antithrombotic agents or requiring large resections, are observed.

Conclusions:

  • Despite advancements, post-ESD bleeding remains a significant concern with unresolved issues.
  • Endoscopists must possess comprehensive knowledge of risk factors and preventive methods for safe ESD performance.
  • Further research is needed to address the challenges of preventing and managing post-ESD bleeding.