Clinical features and predictive factors of coagulation syndrome after endoscopic submucosal dissection for early gastric neoplasm

Hyuk Lee, Kyung Seok Cheoi, Hyunsoo Chung, Jun Chul Park, Sung Kwan Shin, Sang Kil Lee, Yong Chan Lee

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Background Various endoscopic submucosal dissection (ESD)-related complications, such as perforation or bleeding, occur frequently. However, the clinical course of coagulation syndrome (CS) after ESD is not known. The aim of this study was to clarify the clinical outcomes and predictive factors of CS after ESD for early gastric lesions. Methods ESD procedures were performed in the typical sequence (marking, incision, and submucosal dissection). Four hundred and ninety-five patients with early gastric neoplasms were classified into two groups based on their clinical course after ESD: one group with post-ESD CS and the other with a normal clinical course. The clinical outcomes of the CS group were analyzed, and various clinical and pathological factors related to post-ESD CS were investigated using univariate and multivariate analyses. Results Coagulation syndrome occurred after ESD in 35 patients. In the CS group, the median period of inflammatory symptoms was 23.7 ± 12.0 h, and no blood cultures showed bacteremia. Multivariate analysis demonstrated that a tumor size of more than 1.5 cm [odds ratio (OR) 5.99, P<0.001], tumor location in the middle third of the stomach (OR 2.84, P = 0.005), and a procedural time longer than 45 min (OR 2.71, P = 0.033) were independent risk factors for this complication. All patients with CS presented with a favorable outcome, irrespective of antibiotic treatment. Conclusions This study suggests that CS occurs with an incidence of 7.1% after ESD for gastric lesions, and the factors associated with post-ESD CS include tumor size and location, and procedural duration.

Original languageEnglish
Pages (from-to)83-90
Number of pages8
JournalGastric Cancer
Volume15
Issue number1
DOIs
Publication statusPublished - 2012 Jan 1

Fingerprint

Blood Coagulation Factors
Stomach Neoplasms
Stomach
Odds Ratio
Multivariate Analysis
Endoscopic Mucosal Resection
Neoplasms
Bacteremia
Dissection
Hemorrhage
Anti-Bacterial Agents

All Science Journal Classification (ASJC) codes

  • Oncology
  • Gastroenterology
  • Cancer Research

Cite this

Lee, Hyuk ; Cheoi, Kyung Seok ; Chung, Hyunsoo ; Park, Jun Chul ; Shin, Sung Kwan ; Lee, Sang Kil ; Lee, Yong Chan. / Clinical features and predictive factors of coagulation syndrome after endoscopic submucosal dissection for early gastric neoplasm. In: Gastric Cancer. 2012 ; Vol. 15, No. 1. pp. 83-90.
@article{919174e1c8644c65b631656eb4c3f803,
title = "Clinical features and predictive factors of coagulation syndrome after endoscopic submucosal dissection for early gastric neoplasm",
abstract = "Background Various endoscopic submucosal dissection (ESD)-related complications, such as perforation or bleeding, occur frequently. However, the clinical course of coagulation syndrome (CS) after ESD is not known. The aim of this study was to clarify the clinical outcomes and predictive factors of CS after ESD for early gastric lesions. Methods ESD procedures were performed in the typical sequence (marking, incision, and submucosal dissection). Four hundred and ninety-five patients with early gastric neoplasms were classified into two groups based on their clinical course after ESD: one group with post-ESD CS and the other with a normal clinical course. The clinical outcomes of the CS group were analyzed, and various clinical and pathological factors related to post-ESD CS were investigated using univariate and multivariate analyses. Results Coagulation syndrome occurred after ESD in 35 patients. In the CS group, the median period of inflammatory symptoms was 23.7 ± 12.0 h, and no blood cultures showed bacteremia. Multivariate analysis demonstrated that a tumor size of more than 1.5 cm [odds ratio (OR) 5.99, P<0.001], tumor location in the middle third of the stomach (OR 2.84, P = 0.005), and a procedural time longer than 45 min (OR 2.71, P = 0.033) were independent risk factors for this complication. All patients with CS presented with a favorable outcome, irrespective of antibiotic treatment. Conclusions This study suggests that CS occurs with an incidence of 7.1{\%} after ESD for gastric lesions, and the factors associated with post-ESD CS include tumor size and location, and procedural duration.",
author = "Hyuk Lee and Cheoi, {Kyung Seok} and Hyunsoo Chung and Park, {Jun Chul} and Shin, {Sung Kwan} and Lee, {Sang Kil} and Lee, {Yong Chan}",
year = "2012",
month = "1",
day = "1",
doi = "10.1007/s10120-011-0073-x",
language = "English",
volume = "15",
pages = "83--90",
journal = "Gastric Cancer",
issn = "1436-3291",
publisher = "Springer Japan",
number = "1",

}

Clinical features and predictive factors of coagulation syndrome after endoscopic submucosal dissection for early gastric neoplasm. / Lee, Hyuk; Cheoi, Kyung Seok; Chung, Hyunsoo; Park, Jun Chul; Shin, Sung Kwan; Lee, Sang Kil; Lee, Yong Chan.

In: Gastric Cancer, Vol. 15, No. 1, 01.01.2012, p. 83-90.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Clinical features and predictive factors of coagulation syndrome after endoscopic submucosal dissection for early gastric neoplasm

AU - Lee, Hyuk

AU - Cheoi, Kyung Seok

AU - Chung, Hyunsoo

AU - Park, Jun Chul

AU - Shin, Sung Kwan

AU - Lee, Sang Kil

AU - Lee, Yong Chan

PY - 2012/1/1

Y1 - 2012/1/1

N2 - Background Various endoscopic submucosal dissection (ESD)-related complications, such as perforation or bleeding, occur frequently. However, the clinical course of coagulation syndrome (CS) after ESD is not known. The aim of this study was to clarify the clinical outcomes and predictive factors of CS after ESD for early gastric lesions. Methods ESD procedures were performed in the typical sequence (marking, incision, and submucosal dissection). Four hundred and ninety-five patients with early gastric neoplasms were classified into two groups based on their clinical course after ESD: one group with post-ESD CS and the other with a normal clinical course. The clinical outcomes of the CS group were analyzed, and various clinical and pathological factors related to post-ESD CS were investigated using univariate and multivariate analyses. Results Coagulation syndrome occurred after ESD in 35 patients. In the CS group, the median period of inflammatory symptoms was 23.7 ± 12.0 h, and no blood cultures showed bacteremia. Multivariate analysis demonstrated that a tumor size of more than 1.5 cm [odds ratio (OR) 5.99, P<0.001], tumor location in the middle third of the stomach (OR 2.84, P = 0.005), and a procedural time longer than 45 min (OR 2.71, P = 0.033) were independent risk factors for this complication. All patients with CS presented with a favorable outcome, irrespective of antibiotic treatment. Conclusions This study suggests that CS occurs with an incidence of 7.1% after ESD for gastric lesions, and the factors associated with post-ESD CS include tumor size and location, and procedural duration.

AB - Background Various endoscopic submucosal dissection (ESD)-related complications, such as perforation or bleeding, occur frequently. However, the clinical course of coagulation syndrome (CS) after ESD is not known. The aim of this study was to clarify the clinical outcomes and predictive factors of CS after ESD for early gastric lesions. Methods ESD procedures were performed in the typical sequence (marking, incision, and submucosal dissection). Four hundred and ninety-five patients with early gastric neoplasms were classified into two groups based on their clinical course after ESD: one group with post-ESD CS and the other with a normal clinical course. The clinical outcomes of the CS group were analyzed, and various clinical and pathological factors related to post-ESD CS were investigated using univariate and multivariate analyses. Results Coagulation syndrome occurred after ESD in 35 patients. In the CS group, the median period of inflammatory symptoms was 23.7 ± 12.0 h, and no blood cultures showed bacteremia. Multivariate analysis demonstrated that a tumor size of more than 1.5 cm [odds ratio (OR) 5.99, P<0.001], tumor location in the middle third of the stomach (OR 2.84, P = 0.005), and a procedural time longer than 45 min (OR 2.71, P = 0.033) were independent risk factors for this complication. All patients with CS presented with a favorable outcome, irrespective of antibiotic treatment. Conclusions This study suggests that CS occurs with an incidence of 7.1% after ESD for gastric lesions, and the factors associated with post-ESD CS include tumor size and location, and procedural duration.

UR - http://www.scopus.com/inward/record.url?scp=84861527988&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84861527988&partnerID=8YFLogxK

U2 - 10.1007/s10120-011-0073-x

DO - 10.1007/s10120-011-0073-x

M3 - Article

C2 - 21761134

AN - SCOPUS:84861527988

VL - 15

SP - 83

EP - 90

JO - Gastric Cancer

JF - Gastric Cancer

SN - 1436-3291

IS - 1

ER -