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Related Experiment Video

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Delayed Bleeding After Colorectal Endoscopic Submucosal Dissection: When Is Emergency Colonoscopy Needed?

Hideyuki Chiba1, Ken Ohata2, Jun Tachikawa3

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Delayed bleeding after endoscopic submucosal dissection (ESD) for colorectal cancer is linked to rectal lesions and large sizes. A "watch and wait" strategy effectively managed bleeding without emergency colonoscopy.

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Area of Science:

  • Gastroenterology
  • Endoscopic Surgery
  • Colorectal Cancer Treatment

Background:

  • Endoscopic submucosal dissection (ESD) is a key treatment for early colorectal cancer.
  • Delayed bleeding is a significant complication of ESD, but optimal management protocols remain unclear.

Purpose of the Study:

  • To identify risk factors for delayed bleeding post-ESD.
  • To evaluate the efficacy of a
  • watch and wait
  • strategy for managing delayed bleeding.

Main Methods:

  • A retrospective study of 404 patients undergoing endoscopic resection for 439 colorectal lesions.
  • Patients were categorized into bleeding and no-bleeding groups.
  • Risk factors and the necessity of emergency colonoscopy were assessed.

Main Results:

  • Delayed bleeding occurred in 27 patients; 412 had no bleeding.
  • Rectal lesions (OR 5.547) and lesion size ≥40 mm (OR 3.967) were significant risk factors for bleeding.
  • No patient required emergency colonoscopy or blood transfusion under the
  • watch and wait
  • strategy.

Conclusions:

  • Rectal location and larger size (≥40 mm) are risk factors for delayed bleeding after colorectal ESD.
  • The
  • watch and wait
  • approach is safe and effective, avoiding the need for emergency interventions.
  • This strategy minimizes complications and healthcare resource utilization.