Observational studySurgical endoscopy2017
Should antithrombotic therapy be stopped in patients undergoing gastric endoscopic submucosal dissection?
Observational study in Surgical endoscopy, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
33 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Guideline
- Guideline
- [Clinical Practice Guideline for the Management of Antithrombotic Agents in Patients Undergoing Gastrointestinal Endoscopy].The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi · 2020Pooled it
- Heparin-Bridging Therapy and Risk of Bleeding After Endoscopic Submucosal Dissection for Gastric Neoplasms: a Meta-Analysis.Journal of gastrointestinal cancer · 2018Pooled it
- Vonoprazan or Proton Pump Inhibitor for Gastric Endoscopic Submucosal Dissection in Patients Taking Antithrombotic Agents.Journal of gastroenterology and hepatology · 2025Trial
- Endoscopic Closure Utilizing Endoloop and Endoclips After Gastric Endoscopic Submucosal Dissection for Patients on Antithrombotic Therapy.Digestive diseases and sciences · 2021Trial
- Risk of Postoperative Bleeding in Esophageal Endoscopic Submucosal Dissection for Squamous Cell Carcinoma in Patients on Antiplatelet Therapy: A Multicenter Retrospective Study in Japan.Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society · 2026Article
- Endoscopic closure using a dedicated device following gastric endoscopic submucosal dissection: Multicenter, prospective, observational pilot study.Endoscopy international open · 2025Article
- International Digestive Endoscopy Network Consensus on the Management of Antithrombotic Agents in Patients Undergoing Gastrointestinal Endoscopy.Gut and liver · 2024Review
- Spray coagulation reduces the use of hemostatic forceps for intraoperative bleeding in gastric endoscopic submucosal dissection.JGH open : an open access journal of gastroenterology and hepatology · 2024Article
- [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
- Ideal Timing of Discontinuation of Antiplatelet Agents Before Gastric Endoscopic Submucosal Dissection for Reducing Delayed Bleeding.Digestive diseases and sciences · 2023Observational
- Article
- Postoperative Bleeding Risk after Gastric Endoscopic Submucosal Dissection in Patients Receiving a P2Y12 Receptor Antagonist.Gut and liver · 2023Article
- Recent approach for preventing complications in upper gastrointestinal endoscopic submucosal dissection.DEN open · 2022Review
- Effect of Antithrombotic Therapy on Bleeding after Argon Plasma Coagulation for Gastric Neoplasms.Gut and liver · 2022Article
- A narrative review of postoperative bleeding in patients with gastric cancer treated with endoscopic submucosal dissection.Journal of gastrointestinal oncology · 2022Review
- Anticoagulation and antiplatelet management in gastrointestinal endoscopy: A review of current evidence.World journal of gastrointestinal endoscopy · 2020Review
Corrections and comments
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe management of antithrombotic therapy in the patients undergoing gastric endoscopic submucosal dissection (ESD) is of concern. This study aimed to assess delayed bleeding rate after gastric ESD in the patients receiving antithrombotic therapy.
methodsThis study was a retrospective observational study held in a single institute. The patients undergoing gastric ESD from January 2009 to October 2014 were reviewed. Delayed bleeding rate in the patients receiving antithrombotic therapy was compared with that in matched controls. We also compared delayed bleeding rate in the patients continuing antithrombotic therapy with that in the patients with heparin bridging or cessation of antithrombotic therapy. Among 2388 lesions resected by gastric ESD, 367 lesions were resected in the patients with antithrombotic therapy, and 722 lesions were selected as controls. The lesions in the patients receiving antithrombotic therapy were divided into three subgroups: 54 lesions without preoperative cessation (continuation group), 37 lesions with heparin bridging (heparin group), and 276 lesions with cessation of antithrombotic therapy (cessation group).
resultsThe incidence of delayed bleeding was significantly higher in the patients receiving antithrombotic therapy (9.5 % [35/367] vs. 4.2 % [30/722]; p < 0.01). Delayed bleeding rate in continuation group, heparin group, and cessation group was 9.2 % (5/54), 10.8 % (4/37), and 9.4 % (26/276), respectively, and no significant difference was observed. Thrombosis occurred only in cessation group (1.6 %).
conclusionsDelayed bleeding rate associated with gastric ESD is significantly higher in the patients receiving antithrombotic therapy. No significant difference in delayed bleeding rate was observed among patients with and without cessation of antithrombotic therapy. To prevent thrombosis, gastric ESD without cessation may be feasible.
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Registered trials
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