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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 14, 2016; 22(26): 5927-5935
Published online Jul 14, 2016. doi: 10.3748/wjg.v22.i26.5927
Bleeding after endoscopic submucosal dissection: Risk factors and preventive methods
Yosuke Kataoka, Yosuke Tsuji, Yoshiki Sakaguchi, Chihiro Minatsuki, Itsuko Asada-Hirayama, Keiko Niimi, Satoshi Ono, Shinya Kodashima, Nobutake Yamamichi, Mitsuhiro Fujishiro, Kazuhiko Koike
Yosuke Kataoka, Yosuke Tsuji, Yoshiki Sakaguchi, Chihiro Minatsuki, Itsuko Asada-Hirayama, Keiko Niimi, Satoshi Ono, Shinya Kodashima, Nobutake Yamamichi, Mitsuhiro Fujishiro, Kazuhiko Koike, Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
Mitsuhiro Fujishiro, Department of Endoscopy and Endoscopic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
Keiko Niimi, Center for Epidemiology and Preventive Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
Author contributions: Kataoka Y and Tsuji Y contributed to the literature review and manuscript writing; Koike K gave the final approval of the manuscript; All the other authors checked the manuscript and suggested improvement.
Conflict-of-interest statement: Yosuke Tsuji: lecture fees from Olympus Medical Systems, GUNZE and CSL Behring, collaborative research fund from HOYA Pentax; Mitsuhiro Fujishiro: lecture fees from Olympus Medical Systems and CSL Behring, collaborative research fund from HOYA Pentax; the remaining authors declare no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Yosuke Tsuji, MD, PhD, Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. ytsuji-tky@umin.ac.jp
Telephone: +81-3-38155411 Fax: +81-3-58009522
Received: April 11, 2016
Peer-review started: April 13, 2016
First decision: May 12, 2016
Revised: May 30, 2016
Accepted: June 15, 2016
Article in press: June 15, 2016
Published online: July 14, 2016
Processing time: 85 Days and 18.4 Hours
Core Tip

Core tip: Antithrombotic agents and large resection are known to be significant risk factors for post-endoscopic submucosal dissection (post-ESD) bleeding, and as the indications for antithrombotic agents increase, and the indications for endoscopic resection are expanded, endoscopists have a chance to face an increasing number of patients with a high risk of post-ESD bleeding. Acid secretion inhibitors and preventive hemostasis are effective for the prevention of post-ESD bleeding, but do not seem to be completely effective in its prevention. Developing additional preventive methods which can reduce post-ESD bleeding more effectively will become an increasingly important issue in the future.