Risk factors for postoperative bleeding after gastric endoscopic submucosal dissection in patients under antithrombotics

doi:10.4253/wjge.v8.i7.349

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World Journal of Gastrointestinal Endoscopy

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1948-5190

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastrointest Endosc. Apr 10, 2016; 8(7): 349-356
Published online Apr 10, 2016. doi: 10.4253/wjge.v8.i7.349

Table 2 Univariate analysis of postoperative bleeding

	Present (n = 23)	Absent (n = 239)	P value
Patients background factors
Age (yr, mean ± SD) (range)	73 ± 7 (58-82)	71 ± 8 (32-87)	0.4304
Sex (male/female)	7/16	174/65	0.7397
Antithrombotic agent user	10 (43.5%)	38 (15.9%)	0.0011¹
Category of antithrombotic treatment (non-antithrombotic therapy/discontinuation of antithrombotic agents/continuation of antiplatelet agents/heparin replacement)	13/0/2/8	201/25/8/5	< 0.0001¹
Hemodialysis	2 (8.7%)	4 (1.7%)	0.0321¹
Hypertension	10 (43.5%)	120 (50.2%)	0.5375
Diabetes mellitus	1 (4.3%)	53 (22.1%)	0.0435¹
Cardiovascular disease	9 (39.1%)	39 (16.3%)	0.0069¹
PT-INR (mean ± SD) (range)	1.2 ± 0.5 (0.9-2.1)	0.9 ± 0.1 (0.9-2.0)	< 0.0001¹
Charlson comorbidity index (mean ± SD) (range)	3.5 ± 1.2 (1-6)	3.2 ± 1.3 (0-8)	0.2674
Hemoglobin levels on admission (g/dL, mean ± SD) (range)	12.5 ± 1.3 (9.6-14.4)	13.3 ± 1.5 (7.8-17.1)	0.0153¹
Resected lesion factors
Curability (curative/expanding indications curative/non-curative)	19/3/1	156/54/29	0.2305
Macroscopic type (depressed/flat/protruded)	11/11/1	140/90/9	0.6058
Location (upper third/middle third/lower third)	2/3/18	36/70/133	0.0907
Circumference (anterior wall, greater curvature, lesser curvature, posterior wall)	3/4/11/5	35/48/113/43	0.9645
Tumor size (≥ 21 mm)	3 (13.0%)	51 (21.3%)	0.3476
Differentiation (adenoma/differentiated cancer/undifferentiated cancer)	3/2/18	31/198/10	0.6108
Depth (M:SM1:SM2)	22/0/1	214/12/13	0.525
Ulcer findings positive	0 (0%)	16 (6.7%)	0.2003
Lymphovascular infiltration positive	1 (4.3%)	17 (7.1%)	0.6166
Horizontal or vertical margin positive	1 (4.3%)	7 (2.9%)	0.7204
Tumor size (mm, mean ± SD)	17.3 ± 16.1 (6-85)	15.7 ± 10.3 (2-70)	0.5147
Perioperative factors
Operator (beginner/expert)	9/14	88/151	0.8265
Resected size (mm, mean ± SD) (range)	38.9 ± 12.8 (25-88)	35.8 ± 11.5 (12-85)	0.5147
Perforation (%)	1 (4.3%)	1 (0.4%)	0.1286
Operation time (min, mean ± SD) (range)	87.4 ± 63.5 (31-260)	80.9 ± 49.6 (16-307)	0.5608

¹Significantly different. SM: Submucosal layer; PT-INR: Prothrombin time-international normalized ratio.

Citation: Shindo Y, Matsumoto S, Miyatani H, Yoshida Y, Mashima H. Risk factors for postoperative bleeding after gastric endoscopic submucosal dissection in patients under antithrombotics. World J Gastrointest Endosc 2016; 8(7): 349-356
URL: https://www.wjgnet.com/1948-5190/full/v8/i7/349.htm
DOI: https://dx.doi.org/10.4253/wjge.v8.i7.349