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 |
|---|---|
| Pages (from-to) | 285-294 |
| Number of pages | 10 |
| Journal | Gastrointestinal Endoscopy |
| Volume | 78 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - 2013 Aug 1 |
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All Science Journal Classification (ASJC) codes
- Radiology Nuclear Medicine and imaging
- Gastroenterology
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Second-look endoscopy is not associated with better clinical outcomes after gastric endoscopic submucosal dissection : A prospective, randomized, clinical trial analyzed on an as-treated basis. / Ryu, Ho Yoel; Kim, Jae Woo; Kim, Hyun Soo; Park, Hong Jun; Jeon, Hyo Keun; Park, So Yeon; Kim, Bo Ra; Lang, Cui Cui; Won, Sung Ho.
In: Gastrointestinal Endoscopy, Vol. 78, No. 2, 01.08.2013, p. 285-294.Research output: Contribution to journal › Article
TY - JOUR
T1 - Second-look endoscopy is not associated with better clinical outcomes after gastric endoscopic submucosal dissection
T2 - A prospective, randomized, clinical trial analyzed on an as-treated basis
AU - Ryu, Ho Yoel
AU - Kim, Jae Woo
AU - Kim, Hyun Soo
AU - Park, Hong Jun
AU - Jeon, Hyo Keun
AU - Park, So Yeon
AU - Kim, Bo Ra
AU - Lang, Cui Cui
AU - Won, Sung Ho
PY - 2013/8/1
Y1 - 2013/8/1
N2 - 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.)
AB - 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.)
UR - http://www.scopus.com/inward/record.url?scp=84880322869&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84880322869&partnerID=8YFLogxK
U2 - 10.1016/j.gie.2013.02.008
DO - 10.1016/j.gie.2013.02.008
M3 - Article
C2 - 23531425
AN - SCOPUS:84880322869
VL - 78
SP - 285
EP - 294
JO - Gastrointestinal Endoscopy
JF - Gastrointestinal Endoscopy
SN - 0016-5107
IS - 2
ER -