ArticleBMC gastroenterology2014
Risk factors for early and delayed post-operative bleeding after endoscopic submucosal dissection of gastric neoplasms, including patients with continued use of antithrombotic agents.
Article in BMC gastroenterology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
48 citing papers in PubMed, 2 syntheses or guidelines pooled it, 71 citations in OpenAlex.
- Efficacy of Fibrin Sealants and Polyglycolic Acid Sheets in Reducing Postoperative Hemorrhage Following Gastric Endoscopic Submucosal Dissection: A Meta-analysis of Randomized and Observational Studies.Journal of gastrointestinal cancer · 2026Pooled it
- Guideline
- A Randomized Controlled Trial to Evaluate the Effect of Fibrin Glue on Bleeding after Gastric Endoscopic Submucosal Dissection.Gut and liver · 2025Trial
- Controlled hypertension under hemostasis prevents post-gastric endoscopic submucosal dissection bleeding: a prospective randomized controlled trial.Surgical endoscopy · 2021Trial
- Endoscopic Closure Utilizing Endoloop and Endoclips After Gastric Endoscopic Submucosal Dissection for Patients on Antithrombotic Therapy.Digestive diseases and sciences · 2021Trial
- Efficacy of innovative polyglycolic acid sheet device delivery station system: a randomized prospective study.Surgical endoscopy · 2018Trial
- Prediction of delayed bleeding after endoscopic submucosal dissection in early gastric cancer and precancerous lesions by BEST-C score.Surgical endoscopy · 2026Article
- Validation of the BEST-J score and identification of bile reflux as a risk factor for delayed bleeding after gastric endoscopic submucosal dissection.BMC gastroenterology · 2026Article
- Meta-analysis of predictive factors for delayed hemorrhage after endoscopic submucosal dissection in early-stage gastric carcinoma.World journal of gastrointestinal surgery · 2025Article
- Risk modeling of delayed postoperative bleeding after endoscopic submucosal dissection for early colorectal cancer and precancerous lesions.World journal of gastrointestinal surgery · 2025Article
- Prediction and prevention of post-procedural bleedings in patients with cirrhosis.Clinical and molecular hepatology · 2025Review
- International Digestive Endoscopy Network Consensus on the Management of Antithrombotic Agents in Patients Undergoing Gastrointestinal Endoscopy.Gut and liver · 2024Review
- [IDEN Consensus on Management of Antithrombotic Agents in Patients Undergoing Gastrointestinal Endoscopy].The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi · 2024Review
- A Prospective Observational Study on Gastric Endoscopic Submucosal Dissection under Continuous Administration of Antithrombotic Agents.Journal of clinical medicine · 2024Article
- International Digestive Endoscopy Network consensus on the management of antithrombotic agents in patients undergoing gastrointestinal endoscopy.Clinical endoscopy · 2024Review
- Predictive model for bleeding after gastric submucosal dissection before and after guidelines: A single-center retrospective study.DEN open · 2023Article
- Associate factors for endoscopic submucosal dissection operation time and postoperative delayed hemorrhage of early gastric cancer.World journal of gastrointestinal surgery · 2023Article
- Modified BEST-J Score Model Predicts Bleeding after Endoscopic Submucosal Dissection with Fewer Factors.Cancers · 2022Article
- Complete omission of second-look endoscopy after gastric endoscopic submucosal dissection in real-world practice.Medicine · 2022Article
- Utility of a deep learning model and a clinical model for predicting bleeding after endoscopic submucosal dissection in patients with early gastric cancer.World journal of gastroenterology · 2022Article
Corrections and comments
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEndoscopic submucosal dissection (ESD) has become widely accepted as a standard treatment for gastric epithelial neoplasms. Antithrombotic agents are widely used to prevent thromboembolic disease. However, the feasibility of endoscopic procedures for patients using such agents has been rarely investigated. The aim of this study was to identify risk factors for post-operative bleeding after gastric ESD and to evaluate the relationship between the use of antithrombotic agents and post-operative bleeding.
methodsFrom June 2005 to March 2014, 413 patients with 425 gastric neoplasms were treated by ESD. The demographic and clinical parameters associated with post-operative bleeding were investigated. 83 patients receiving antithrombotic agents were separately assessed using various methods of administration during the ESD procedure. Post-operative bleeding that occurred within 5 days of ESD was defined as early post-operative bleeding, whereas subsequent bleeding was defined as delayed bleeding.
resultsThe overall post-operative bleeding rate was 4.7%. In patients with continued low-dose aspirin (LDA), heparin replacement (HR), or continued LDA along with HR, post-operative bleeding rates were 9.5%, 23.8%, and 25.0%, respectively. On multivariate analysis, a specimen size of ≥40 mm was a risk factor for early post-operative bleeding [odds ratio (OR) 6.08, 95% CI: 1.74-21.27], and HR and chronic kidney disease (CKD) requiring hemodialysis were risk factors for delayed bleeding (OR 12.23, 95% CI: 2.63-56.77 and OR 28.35, 95% CI: 4.67-172.11, respectively). Continued LDA was not a risk factor for post-operative bleeding.
conclusionsLarge specimen size is a risk factor for early post-operative bleeding, and HR and CKD requiring hemodialysis are risk factors for delayed bleeding. Patients with risk factors should be carefully watched, allowing for the timing of post-operative bleeding after ESD.
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