Abstract
Background: The efficacy of routine second-look endoscopy (SLE) to detect or prevent bleeding after gastric endoscopic submucosal dissection (ESD) has not yet been validated. Objective: The aim of this study was to determine whether SLE affects clinical outcomes including bleeding and morbidity after gastric ESD. Design: A prospective, randomized, controlled study with consecutive data analyzed on an as-treated basis. Setting: A single, tertiary-care referral center. Patients: A total of 182 patients. Intervention: Gastric ESD and SLE. Main Outcome Measurements: Incidence of and risk factors related to bleeding after ESD and outcomes by univariate or multivariate analysis. Results: Among 182 patients enrolled, 74 and 81 patients were assigned to the SLE and no-SLE groups, respectively. Two groups were observed closely for 4 weeks. Bleeding occurred after ESD in 21 patients (13.5%). Hemoglobin loss (≥2.0 g/dL) was observed in 20 patients, and melena developed in 1 patient after ESD. However, only 1 patient needed a transfusion. Twelve patients (16.2%) in the SLE group and 9 in the no-SLE group (11.1%) experienced bleeding after ESD. The frequency of bleeding after ESD was not significantly different between the 2 groups (P =.66). There were no risk factors related to bleeding after ESD. Limitations: Single-center analysis. Conclusion: SLE is not routinely necessary because it does not affect clinical outcomes, including bleeding and morbidity after ESD. (Clinical trial registration number: KCT0000146.)
Original language | English |
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Pages (from-to) | 285-294 |
Number of pages | 10 |
Journal | Gastrointestinal endoscopy |
Volume | 78 |
Issue number | 2 |
DOIs | |
Publication status | Published - 2013 Aug |
All Science Journal Classification (ASJC) codes
- Radiology Nuclear Medicine and imaging
- Gastroenterology