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Efficacy of second‑look endoscopy in preventing delayed bleeding after endoscopic submucosal dissection of early gastric cancer

  • Authors:
    • Zhiguo Guo
    • Lin Miao
    • Lijuan Chen
    • Hongsheng Hao
    • Yi Xin
  • View Affiliations / Copyright

    Affiliations: Department of Gastroenterology, Suzhou Municipal Hospital, Suzhou, Anhui 234000, P.R. China, Medical Center for Digestive Diseases, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210011, P.R. China, Department of Gastroenterology, Central Hospital of Shandong Energy Zaozhuang Mining Group, Zaozhuang, Shandong 277100, P.R. China, Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, P.R. China
    Copyright: © Guo et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Pages: 3855-3862
    |
    Published online on: September 12, 2018
       https://doi.org/10.3892/etm.2018.6729
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Abstract

The present study aimed to evaluate whether second‑look endoscopy (SLE) is able to prevent delayed bleeding after endoscopic submucosal dissection (ESD) of gastric carcinoma and to identify which types of lesion require SLE. ESD of gastric cancer at the early stage was performed on 210 patients between October 2014 and September 2016. Mucosal damage‑associated bleeding within 24 h after ESD was considered as delayed bleeding. The association of the characteristics of patients and lesions, as well as surgical factors, with the incidence of bleeding as a measure of outcome was analyzed. A total of 110 patients with melena and/or hematemesis underwent SLE on the second day following gastric ESD. Within the entire cohort (n=210), late delayed bleeding (LDB) was defined as hematemesis or melena occurring following second‑look endoscopy. Early delayed bleeding (EDB) was defined as hematemesis or melena occurring from the end of ESD to second‑look endoscopy, or as active or possible bleeding at the time of the second‑look endoscopy was reported in 17 (8.1%) and 20 patients(9.5%), respectively. The median interval between late delayed bleeding and ESD was one day (range, 1‑10 days). The incidence of late delayed bleeding was significantly decreased in the SLE group compared with that in the non‑SLE group (4.5 vs. 12%, P=0.028). Multivariate analyses revealed that ulcer, flat gross type, lesion diameter (>2 cm), the resected tumor size of >40 mm and Helicobacter pylori infection were independently associated with late delayed bleeding after ESD, while flat gross type, ulcer, the resected tumor size of >40 mm and artificial ulcer diameter >3 cm were independently associated with early delayed bleeding. Thus, the data of the present study indicates that second‑look endoscopy following gastric ESD may be useful in preventing post‑ESD delayed bleeding and should be performed on the second day.
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Copy and paste a formatted citation
Spandidos Publications style
Guo Z, Miao L, Chen L, Hao H and Xin Y: Efficacy of second‑look endoscopy in preventing delayed bleeding after endoscopic submucosal dissection of early gastric cancer. Exp Ther Med 16: 3855-3862, 2018.
APA
Guo, Z., Miao, L., Chen, L., Hao, H., & Xin, Y. (2018). Efficacy of second‑look endoscopy in preventing delayed bleeding after endoscopic submucosal dissection of early gastric cancer. Experimental and Therapeutic Medicine, 16, 3855-3862. https://doi.org/10.3892/etm.2018.6729
MLA
Guo, Z., Miao, L., Chen, L., Hao, H., Xin, Y."Efficacy of second‑look endoscopy in preventing delayed bleeding after endoscopic submucosal dissection of early gastric cancer". Experimental and Therapeutic Medicine 16.5 (2018): 3855-3862.
Chicago
Guo, Z., Miao, L., Chen, L., Hao, H., Xin, Y."Efficacy of second‑look endoscopy in preventing delayed bleeding after endoscopic submucosal dissection of early gastric cancer". Experimental and Therapeutic Medicine 16, no. 5 (2018): 3855-3862. https://doi.org/10.3892/etm.2018.6729
Copy and paste a formatted citation
x
Spandidos Publications style
Guo Z, Miao L, Chen L, Hao H and Xin Y: Efficacy of second‑look endoscopy in preventing delayed bleeding after endoscopic submucosal dissection of early gastric cancer. Exp Ther Med 16: 3855-3862, 2018.
APA
Guo, Z., Miao, L., Chen, L., Hao, H., & Xin, Y. (2018). Efficacy of second‑look endoscopy in preventing delayed bleeding after endoscopic submucosal dissection of early gastric cancer. Experimental and Therapeutic Medicine, 16, 3855-3862. https://doi.org/10.3892/etm.2018.6729
MLA
Guo, Z., Miao, L., Chen, L., Hao, H., Xin, Y."Efficacy of second‑look endoscopy in preventing delayed bleeding after endoscopic submucosal dissection of early gastric cancer". Experimental and Therapeutic Medicine 16.5 (2018): 3855-3862.
Chicago
Guo, Z., Miao, L., Chen, L., Hao, H., Xin, Y."Efficacy of second‑look endoscopy in preventing delayed bleeding after endoscopic submucosal dissection of early gastric cancer". Experimental and Therapeutic Medicine 16, no. 5 (2018): 3855-3862. https://doi.org/10.3892/etm.2018.6729
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