Strategies that Reduce Post-endoscopic Submucosal Dissection Bleeding
Bleeding after endoscopic submucosal dissection (ESD), one of the most common postprocedural adverse events, is the main cause of increased readmission rates and hospital costs. Generally, the incidence of post-ESD bleeding is estimated to be about 5%. However, the incidence of bleeding is particula...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
Yong Chan Lee
2021-09-01
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| Series: | The Korean Journal of Helicobacter and Upper Gastrointestinal Research |
| Subjects: | |
| Online Access: | http://www.helicojournal.org/upload/pdf/kjhugr-2021-0028.pdf |
| _version_ | 1819082514102222848 |
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| author | Da Hyun Jung Jun Chul Park |
| author_facet | Da Hyun Jung Jun Chul Park |
| author_sort | Da Hyun Jung |
| collection | DOAJ |
| description | Bleeding after endoscopic submucosal dissection (ESD), one of the most common postprocedural adverse events, is the main cause of increased readmission rates and hospital costs. Generally, the incidence of post-ESD bleeding is estimated to be about 5%. However, the incidence of bleeding is particularly increased in high-risk patients. In particular, it has an incidence of over 50% in patients that use antithrombotic agents. The well-known risk factors for post-ESD bleeding include antithrombotic therapy, lesions in the proximal stomach, specimen size >4 cm, and concomitant renal disease. Currently, the number of patients at a high risk of post-ESD bleeding has been increasing. This may be due to the aging society and the increase in the usage of antithrombotic agents. Therefore, several strategies have been employed to prevent post-ESD bleeding. These strategies include acid inhibition therapy, preventive hemostasis using Doppler endoscopic ultrasound and artery-selective clipping, second look endoscopy, the closings method, and the shield methods. However, these methods are technically demanding, which hinders their wide usage in clinical practice. Recently, several hemostatic powders have been developed and clinically used in the treatment of gastrointestinal bleeding. In this article, we review the risk factors for post-ESD bleeding and the recently introduced prevention methods. Moreover, we aimed to explore realistic and appropriate strategies for the prevention of post-ESD bleeding. |
| first_indexed | 2024-12-21T20:17:53Z |
| format | Article |
| id | doaj.art-dc5ecfc29a55408b9385eb61478c453b |
| institution | Directory Open Access Journal |
| issn | 1738-3331 |
| language | English |
| last_indexed | 2024-12-21T20:17:53Z |
| publishDate | 2021-09-01 |
| publisher | Yong Chan Lee |
| record_format | Article |
| series | The Korean Journal of Helicobacter and Upper Gastrointestinal Research |
| spelling | doaj.art-dc5ecfc29a55408b9385eb61478c453b2022-12-21T18:51:34ZengYong Chan LeeThe Korean Journal of Helicobacter and Upper Gastrointestinal Research1738-33312021-09-0121319420210.7704/kjhugr.2021.0028689Strategies that Reduce Post-endoscopic Submucosal Dissection BleedingDa Hyun Jung0Jun Chul Park1 Department of Gastroenterology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea Department of Gastroenterology, Severance Hospital, Yonsei University College of Medicine, Seoul, KoreaBleeding after endoscopic submucosal dissection (ESD), one of the most common postprocedural adverse events, is the main cause of increased readmission rates and hospital costs. Generally, the incidence of post-ESD bleeding is estimated to be about 5%. However, the incidence of bleeding is particularly increased in high-risk patients. In particular, it has an incidence of over 50% in patients that use antithrombotic agents. The well-known risk factors for post-ESD bleeding include antithrombotic therapy, lesions in the proximal stomach, specimen size >4 cm, and concomitant renal disease. Currently, the number of patients at a high risk of post-ESD bleeding has been increasing. This may be due to the aging society and the increase in the usage of antithrombotic agents. Therefore, several strategies have been employed to prevent post-ESD bleeding. These strategies include acid inhibition therapy, preventive hemostasis using Doppler endoscopic ultrasound and artery-selective clipping, second look endoscopy, the closings method, and the shield methods. However, these methods are technically demanding, which hinders their wide usage in clinical practice. Recently, several hemostatic powders have been developed and clinically used in the treatment of gastrointestinal bleeding. In this article, we review the risk factors for post-ESD bleeding and the recently introduced prevention methods. Moreover, we aimed to explore realistic and appropriate strategies for the prevention of post-ESD bleeding.http://www.helicojournal.org/upload/pdf/kjhugr-2021-0028.pdfbleedingendoscopic submucosal dissectionhemostasis |
| spellingShingle | Da Hyun Jung Jun Chul Park Strategies that Reduce Post-endoscopic Submucosal Dissection Bleeding The Korean Journal of Helicobacter and Upper Gastrointestinal Research bleeding endoscopic submucosal dissection hemostasis |
| title | Strategies that Reduce Post-endoscopic Submucosal Dissection Bleeding |
| title_full | Strategies that Reduce Post-endoscopic Submucosal Dissection Bleeding |
| title_fullStr | Strategies that Reduce Post-endoscopic Submucosal Dissection Bleeding |
| title_full_unstemmed | Strategies that Reduce Post-endoscopic Submucosal Dissection Bleeding |
| title_short | Strategies that Reduce Post-endoscopic Submucosal Dissection Bleeding |
| title_sort | strategies that reduce post endoscopic submucosal dissection bleeding |
| topic | bleeding endoscopic submucosal dissection hemostasis |
| url | http://www.helicojournal.org/upload/pdf/kjhugr-2021-0028.pdf |
| work_keys_str_mv | AT dahyunjung strategiesthatreducepostendoscopicsubmucosaldissectionbleeding AT junchulpark strategiesthatreducepostendoscopicsubmucosaldissectionbleeding |