Second-look endoscopy and factors associated with delayed bleeding after endoscopic submucosal dissection

Table 3 Antiplatelet medication and the risk of delayed bleeding

Ref.	Year	n	Design	Method	Comparison of bleeding incidence	Comments
Lim et al[32]	2012	1591	Retrospective	ESD	No antiplatelet medication: 5.2% Antiplatelet withdrawal: 5.9% Antiplatelet continuation: 11.6%	Continuous administration of antiplatelet medication was not found to have an independent significant association with bleeding
Cho et al[33]	2012	514	Retrospective	ESD	No aspirin medication: 3.4% Aspirin withdrawal: 3.6% Aspirin continuation: 21.1%	Continuous aspirin use increases the risk of bleeding after gastric ESD
Sanomura et al[35]	2014	94	Retrospective	ESD	Aspirin interruption: 7.1% Aspirin continuation: 4.8%	Continued use of aspirin does not increase the risk of bleeding during or after ESD
Tounou et al[34]	2015	377	Retrospective	ESD	No aspirin medication: 6.1% Aspirin continuation: 14.4% Single antiplatelet: 15.5% Dual antiplatelet: 35.5%	Aspirin was not a significant risk factor for post-ESD bleeding
Ono et al[36]	2015	28	Prospective, observational	ESD/EMR	The study was terminated in accordance with predetermined safety criteria because 7 of 28 consecutive patients experienced major bleeding complications (25.0%)	Subanalysis of gastric ESD (23 lesions in 19 patients) confirmed that the administration of thienopyridine derivatives (P = 0.01) and multiple agents (P = 0.02) were the significant factors Continuation of aspirin alone during these endoscopic procedures may be acceptable

ESD: Endoscopic submucosal dissection; EMR: Endoscopic mucosal resection.