| ID | 61261 |
| FullText URL | |
| Author |
Hamada, Kenta
Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Kanzaki, Hiromitsu
Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
ORCID
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Inoue, Masafumi
Department of Gastroenterology, Japanese Red Cross Okayama Hospital
Ishiyama , Shuhei
Department of Internal Medicine, Okayama Saiseikai General Hospital
Yamauchi, Kenji
Department of Gastroenterology, Mitoyo General Hospital
Miyahara, Koji
Department of Internal Medicine, Hiroshima City Hospital
Toyokawa, Tatsuya
Department of Gastroenterology, National Hospital Organization Fukuyama Medical Center
Tsuzuki, Takao
Department of Internal Medicine, Japanese Red Cross Society Himeji Hospital
Miyaike, Jiro
Department of Internal Medicine, Saiseikai Imabari Hospital
Matsubara, Minoru
Department of Internal Medicine, Sumitomo Besshi Hospital
Takahashi, Sakuma
Department of Gastroenterology, Kagawa Prefectural Central Hospital
Nishimura, Mamoru
Department of Internal Medicine, Okayama City Hospital
Takenaka, Ryuta
Department of Internal Medicine, Tsuyama Chuo Hospital
Yunoki, Naoko
Department of Internal Medicine, Akaiwa Medical Association Hospital
Hori, Shinichiro
Department of Endoscopy, National Hospital Organization Shikoku Cancer Center
Kobayashi, Sayo
Department of Internal Medicine, Fukuyama City Hospital
Kawahara, Yoshiro
Department of Endoscopy, Okayama University Hospital
Ishikawa, Hideki
Department of Molecular-Targeting Cancer Prevention, Kyoto Prefectural University of Medicine
Okada, Hiroyuki
Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Kaken ID
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| Abstract | Objective Gastric endoscopic submucosal dissection (ESD) under heparin replacement (HR) of warfarin reportedly has a high risk of delayed bleeding (24-57%). It is possible that the delayed bleeding risk may have changed over the years. We evaluated the current risk of delayed bleeding after gastric ESD under HR of anticoagulant agents.
Methods We retrospectively reviewed the delayed bleeding rate and analyzed the risk factors for delayed bleeding.
Patients Consecutive patients who underwent gastric ESD under HR of anticoagulant agents from July 2015 to June 2017.
Results A total of 32 patients with a solitary early gastric cancer and taking anticoagulant agents were analyzed, including 24 patients on warfarin (the warfarin group) and 8 patients on direct oral anticoagulants (the DOAC group). Three (9.4%) patients experienced delayed bleeding: three (12.5%) patients in the warfarin group and no patients in the DOAC group. Continued aspirin treatment was identified to be a risk factor of delayed bleeding (p=0.01).
Conclusion Careful management may be required for patients undergoing gastric ESD under continued aspirin treatment in addition to HR of anticoagulant agents; although the delayed bleeding risk after gastric ESD under HR of anticoagulant agents might have decreased over the years.
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| Keywords | anticoagulant agent
bleeding
endoscopic submucosal dissection
gastric cancer
heparin replacement
warfarin
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| Published Date | 2020-11-01
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| Publication Title |
Internal Medicine
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| Volume | volume59
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| Issue | issue21
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| Publisher | The Japanese Society of Internal Medicine
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| Start Page | 2643
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| End Page | 2651
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| ISSN | 0918-2918
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| NCID | AA10827774
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| Content Type |
Journal Article
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| language |
English
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| OAI-PMH Set |
岡山大学
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| Copyright Holders | © 2020 by The Japanese Society of Internal Medicine
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| File Version | publisher
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| PubMed ID | |
| DOI | |
| Web of Science KeyUT | |
| Related Url | isVersionOf https://doi.org/10.2169/internalmedicine.4998-20
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| License | https://creativecommons.org/licenses/by-nc-nd/4.0/
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