A Multicenter Survey of the Management After Gastric Endoscopic Submucosal Dissection Related to Postoperative Bleeding

被引：106

作者：

Goto, Osamu ^{[1
]}

Fujishiro, Mitsuhiro ^{[2
]}

Oda, Ichiro ^{[3
]}

Kakushima, Naomi ^{[4
]}

Yamamoto, Yorimasa ^{[5
]}

Tsuji, Yosuke ^{[6
]}

Ohata, Ken ^{[6
]}

Fujiwara, Takashi ^{[7
]}

Fujiwara, Junko ^{[7
]}

Ishii, Naoki ^{[8
]}

Yokoi, Chizu ^{[9
]}

Miyamoto, Shinichi ^{[10
]}

Itoh, Toshiyuki ^{[10
]}

Morishita, Shinji ^{[11
]}

Gotoda, Takuji ^{[9
]}

Koike, Kazuhiko ^{[1
]}

机构：

[1] Univ Tokyo, Grad Sch Med, Dept Gastroenterol, Bunkyo Ku, Tokyo, Japan

[2] Univ Tokyo, Grad Sch Med, Dept Endoscopy & Endoscop Surg, Tokyo, Japan

[3] Natl Canc Ctr, Endoscopy Div, Tokyo, Japan

[4] Shizuoka Canc Ctr, Endoscopy Div, Shizuoka, Japan

[5] Canc Inst Hosp, Dept Gastroenterol, Tokyo, Japan

[6] NTT Med Ctr Tokyo, Dept Gastroenterol, Tokyo, Japan

[7] Komagome Hosp, Tokyo Metropolitan Canc & Infect Dis Ctr, Dept Gastroenterol, Tokyo, Japan

[8] St Lukes Int Hosp, Dept Gastroenterol, Tokyo, Japan

[9] Natl Ctr Global Hlth & Med, Dept Gastroenterol, Tokyo, Japan

[10] Kyoto Univ, Dept Gastroenterol, Kyoto, Japan

[11] Tokyo Koseinenkin Hosp, Dept Gastroenterol, Tokyo, Japan

来源：

DIGESTIVE DISEASES AND SCIENCES | 2012年 / 57卷 / 02期

关键词：

Endoscopic submucosal dissection; Gastric epithelial neoplasms; Postoperative bleeding; Second-look endoscopy; PROTON PUMP INHIBITOR; H-2-RECEPTOR ANTAGONIST; RISK-FACTORS; ULCER; CANCER;

D O I：

10.1007/s10620-011-1886-5

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

100201 [内科学];

摘要：

Bleeding is a major complication after gastric endoscopic submucosal dissection (ESD). An evidence-based strategy for postoperative care related to delayed bleeding is required. We conducted a multicenter survey to assess the current status of management after gastric ESD. A total of 1,814 gastric epithelial neoplasms in 2009 at ten tertiary referral centers were enrolled. The current status of the management after gastric ESD (use of an antisecretory drug, food intake, and second-look endoscopy) at participating hospitals was assessed. Furthermore, the rate of post-ESD bleeding and the differences in each parameter were retrospectively analyzed. Postoperative bleeding occurred in 100 cases (5.5%), which included 62 cases of bleeding within 24 h after ESD. In all of the hospitals, proton pump inhibitors (PPIs) were used. The median administration period was 56 days (range 14-60 days). Food intake was resumed from postoperative day (POD) 1 in 4 hospitals and from POD 2 in 6 hospitals. Second-look endoscopy was performed for almost all cases, fewer cases, and rarely or none in 6, 2, and 2 hospitals, respectively. The day of second-look endoscopy varied among hospitals. There was no statistical relationship between the postoperative bleeding rate and the differences in these three parameters. Post-ESD management (duration of PPI use, resumption of food intake, and performance of second-look endoscopy) varied among the medical centers; thus, randomized controlled trials are required for an optimal strategy after gastric ESD.

引用

页码：435 / 439

页数：5

共 17 条

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