Risk factors for bleeding after endoscopic mucosal resection

doi:10.3748/wjg.v11.i46.7335

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Dec 14, 2005 (publication date) through Nov 28, 2024

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World Journal of Gastroenterology

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1007-9327

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

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World J Gastroenterol. Dec 14, 2005; 11(46): 7335-7339
Published online Dec 14, 2005. doi: 10.3748/wjg.v11.i46.7335

Risk factors for bleeding after endoscopic mucosal resection

Masatsugu Shiba, Kazuhide Higuchi, Kaori Kadouchi, Ai Montani, Kazuki Yamamori, Hirotoshi Okazaki, Makiko Taguchi, Tomoko Wada, Atsushi Itani, Toshio Watanabe, Kazunari Tominaga, Yoshihiro Fujiwara, Tomoshige Hayashi, Kei Tsumura, Tetsuo Arakawa

Tomoshige Hayashi, Department of Preventive Medicine and Environmental Health, Osaka City University Medical School, Osaka, Japan

Kei Tsumura, Department of Cardiology, Osaka City University Medical School, Osaka, Japan

Author contributions: All authors contributed equally to the work.

Correspondence to: Kazuhide Higuchi, MD, Department of Gastroenterology, Osaka City University Medical School, 1-4-3, Asahi-machi, Abeno-ku, Osaka 545-8585, Japan. khiguchi@med.osaka-cu.ac.jp

Telephone: +81-6-66452341 Fax: +81-6-66452341

Received: April 1, 2005
Revised: April 23, 2005
Accepted: April 30, 2005
Published online: December 14, 2005

Abstract

AIM: To clarify the risk factors for bleeding after endoscopic mucosal resection (EMR).

METHODS: A total of 297 consecutive patients who underwent EMR were enrolled. Some of the patients had multiple lesions. Bleeding requiring endoscopic treatment was defined as bleeding after EMR. Odds ratios (OR) with 95% confidence intervals (CI), calculated by logistic regression with multivariate adjustments for covariates, were the measures of association.

RESULTS: Of the 297 patients, 57 (19.2%) patients with bleeding after EMR were confirmed. With multivariate adjustment, the cutting method of EMR, diameter, and endoscopic pattern of the tumor were associated with the risk of bleeding after EMR. The multivariate-adjusted OR for bleeding after EMR using endoscopic aspiration mucosectomy was 3.07 (95%CI, 1.59-5.92) compared with strip biopsy. The multiple-adjusted OR for bleeding after EMR for the highest quartile (16-50 mm) of tumor diameter was 5.63 (95%CI, 1.84-17.23) compared with that for the lowest (4-7 mm). The multiple-adjusted OR for bleeding after EMR for depressed type of tumor was 4.21 (95%CI, 1.75-10.10) compared with elevated type.

CONCLUSION: It is important to take tumor characteristics (tumor size and endoscopic pattern) and cutting method of EMR into consideration in predicting bleeding after EMR.

Keywords: Endoscopic mucosal resection; Bleeding; Tumor characteristics; Cutting method