Sato C, Hirasawa K, Koh R, Ikeda R, Fukuchi T, Kobayashi R, Kaneko H, Makazu M, Maeda S. Postoperative bleeding in patients on antithrombotic therapy after gastric endoscopic submucosal dissection. World J Gastroenterol 2017; 23(30): 5557-5566 [PMID: 28852315 DOI: 10.3748/wjg.v23.i30.5557]
Corresponding Author of This Article
Kingo Hirasawa, MD, PhD, Endoscopy Division, Yokohama Medical University Center Hospital, 4-57, Urafune-cho, Minami-ku, Yokohama 232-0024, Japan. kingo-h@urahp.yokohama-cu.ac.jp
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
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/
Chiko Sato, Kingo Hirasawa, Ryonho Koh, Ryosuke Ikeda, Takehide Fukuchi, Ryosuke Kobayashi, Hiroaki Kaneko, Makomo Makazu, Endoscopy Division, Yokohama City University Medical Center, Yokohama 232-0024, Japan
Shin Maeda, Department of Gastroenterology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan
Author contributions: Sato C and Hirasawa K contributed to conception and design; Sato C, Hirasawa K, Koh R, Ikeda R, Fukuchi T, Kobayashi R, Kaneko H and Makazu M contributed to acquisition of data; Sato C and Hirasawa K contributed to analysis and interpretation of data; Hirasawa K contributed to drafting of the article; Hirasawa K and Maeda S contributed to critical revision of the article; Sato C and Hirasawa K contributed to statistical analysis; Hirasawa K and Maeda S final approved the article; all authors listed have contributed substantially to the design, data collection and analysis, and editing of the manuscript.
Institutional review board statement: This research was approved by the research ethics committee in our hospital (Approval number: D1602024).
Informed consent statement: Patients were not required to provide informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All the authors have no conflict of interest related to the manuscript.
Data sharing statement: No additional data are available.
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: Kingo Hirasawa, MD, PhD, Endoscopy Division, Yokohama Medical University Center Hospital, 4-57, Urafune-cho, Minami-ku, Yokohama 232-0024, Japan. kingo-h@urahp.yokohama-cu.ac.jp
Telephone: +81-45-2615656 Fax: +81-45-2535382
Received: May 17, 2017 Peer-review started: May 19, 2017 First decision: June 8, 2017 Revised: June 26, 2017 Accepted: July 12, 2017 Article in press: July 12, 2017 Published online: August 14, 2017 Processing time: 89 Days and 1.9 Hours
Core Tip
Core tip: The major complication of gastric endoscopic submucosal dissection (ESD) is postoperative bleeding. Previous studies reported the relationship between postoperative bleeding and antithrombotic agents. We aimed to investigate postoperative bleeding following gastric ESD in relation to specific antithrombotic agents. We showed that antithrombotic agents, in particular heparin bridging therapy and dual antiplatelet therapy/multidrug combination, were independent risk factors for delayed bleeding. Furthermore, bleeding in the early period was significantly higher for warfarin, and bleeding in the late period was significantly higher for multidrug combination. We must strictly observe multidrug combination users especially after discharge.
