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Risk Factors for Post-gastric Endoscopic Submucosal Dissection Bleeding with a Special Emphasis on Anticoagulant Therapy

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Abstract

Background

Little is known about the risk factors for post endoscopic submucosal dissection (post-ESD) bleeding with anticoagulant therapy.

Aims

We aimed to investigate the risk factors for post-ESD bleeding for early gastric cancer (EGC) with an emphasis on anticoagulant therapy.

Methods

We retrospectively analyzed 2355 EGCs, including 137 lesions in patients treated under anticoagulants. Clinicopathological findings were evaluated between lesions in patients with and without anticoagulant therapy with propensity score matching analysis. The factors associated with post-ESD bleeding were analyzed with multivariate analysis with a logistic regression method.

Results

After propensity score matching, post-ESD bleeding was significantly more frequent in lesions of patients with than without anticoagulant therapy (11.7% vs 1.5%, respectively; P = 0.001). A univariate analysis revealed that anticoagulant therapy, heparin bridge therapy, undifferentiated type, deep submucosal invasion, and resected specimen size were associated with post-ESD bleeding. A multivariate analysis revealed anticoagulant therapy (OR 23.1, 95% CI 3.61–147.52) and resected specimen size (OR 1.03, 95% CI 1.00–1.06) to be independent factors associated with post-ESD bleeding.

Conclusions

Anticoagulant therapy and resected specimen size were risk factors associated with post-ESD bleeding for EGC.

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Authors and Affiliations

  1. Division of Gastroenterology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Uchimaru 19-1, Morioka, 020-8505, Japan

    Yosuke Toya, Masaki Endo, Tomofumi Oizumi, Risaburo Akasaka, Shunichi Yanai, Keisuke Kawasaki, Shotaro Nakamura & Takayuki Matsumoto

  2. Kaiunbashi Endoscopy Clinic, Morioka, Japan

    Masaki Endo

  3. Division of Molecular Diagnostic Pathology, Department of Pathology, School of Medicine, Iwate Medical University, Morioka, Japan

    Makoto Eizuka, Yasuko Fujita, Noriyuki Uesugi & Tamotsu Sugai

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  1. Yosuke Toya
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Correspondence to Yosuke Toya.

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Toya, Y., Endo, M., Oizumi, T. et al. Risk Factors for Post-gastric Endoscopic Submucosal Dissection Bleeding with a Special Emphasis on Anticoagulant Therapy. Dig Dis Sci 65, 557–564 (2020). https://doi.org/10.1007/s10620-019-05776-3

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  • DOI: https://doi.org/10.1007/s10620-019-05776-3

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