Gastric ESD under Heparin Replacement at High-Risk Patients of Thromboembolism Is Technically Feasible but Has a High Risk of Delayed Bleeding: Osaka University ESD Study Group
Objectives. Heparin replacement (HR) is often performed in patients with a high risk of thrombosis undergoing endoscopic procedures. However, information about the influence of HR is scarce. The aim of this study is to assess the clinical impact of HR for gastric endoscopic submucosal dissection (ES...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2013-01-01
|
| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2013/365830 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832566932710096896 |
|---|---|
| author | Toshiyuki Yoshio Tsutomu Nishida Naoki Kawai Kiyonori Yuguchi Takuya Yamada Takamasa Yabuta Masato Komori Shinjiro Yamaguchi Shinji Kitamura Hideki Iijima Shusaku Tsutsui Tomoki Michida Eiji Mita Masahiko Tsujii Tetsuo Takehara |
| author_facet | Toshiyuki Yoshio Tsutomu Nishida Naoki Kawai Kiyonori Yuguchi Takuya Yamada Takamasa Yabuta Masato Komori Shinjiro Yamaguchi Shinji Kitamura Hideki Iijima Shusaku Tsutsui Tomoki Michida Eiji Mita Masahiko Tsujii Tetsuo Takehara |
| author_sort | Toshiyuki Yoshio |
| collection | DOAJ |
| description | Objectives. Heparin replacement (HR) is often performed in patients with a high risk of thrombosis undergoing endoscopic procedures. However, information about the influence of HR is scarce. The aim of this study is to assess the clinical impact of HR for gastric endoscopic submucosal dissection (ESD).
Methods. This is a retrospective study comprising approximately 1310 consecutive gastric neoplasms in 1250 patients, who underwent ESD in 5 institutes. We assessed the clinical findings and outcomes of ESD under HR, compared to ESD without HR as control.
Results. A total of 24 EGC lesions in 24 patients were treated by ESD under HR. In the HR group, the complete en-bloc resection rate was 100%. The delayed bleeding rate was, however, higher in the HR group than in the controls (38% versus 4.6%). The timing of bleeding in the HR group was significantly later than in controls. In the control group, 209 patients discontinued antithrombotic therapy during perioperative period, and their delayed bleeding rate was not different from those without antithrombotic therapy (5.7% versus. 4.4%). A thromboembolic event was encountered in 1 patient under HR after delayed bleeding.
Conclusion. ESD under HR is technically feasible but has a high risk of delayed bleeding. |
| format | Article |
| id | doaj-art-f20b33ef40ea4b1d8c3648667fe930b4 |
| institution | Kabale University |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Gastroenterology Research and Practice |
| spelling | doaj-art-f20b33ef40ea4b1d8c3648667fe930b42025-02-03T01:02:50ZengWileyGastroenterology Research and Practice1687-61211687-630X2013-01-01201310.1155/2013/365830365830Gastric ESD under Heparin Replacement at High-Risk Patients of Thromboembolism Is Technically Feasible but Has a High Risk of Delayed Bleeding: Osaka University ESD Study GroupToshiyuki Yoshio0Tsutomu Nishida1Naoki Kawai2Kiyonori Yuguchi3Takuya Yamada4Takamasa Yabuta5Masato Komori6Shinjiro Yamaguchi7Shinji Kitamura8Hideki Iijima9Shusaku Tsutsui10Tomoki Michida11Eiji Mita12Masahiko Tsujii13Tetsuo Takehara14Department of Gastroenterology, Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-ku, Osaka 540-0006, JapanDepartment of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Clinical Research Building (K1), 2-2 Yamadaoka, Suita, Osaka 565-0871, JapanDepartment of Gastroenterology, Osaka Police Hospital, Kitayama-cho, Tennoji-ku, Osaka 543-0035, JapanDepartment of Gastroenterology, Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-ku, Osaka 540-0006, JapanDepartment of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Clinical Research Building (K1), 2-2 Yamadaoka, Suita, Osaka 565-0871, JapanDepartment of Gastroenterology, Sakai City Hospital, 1-1-1 Minamiyasui-cho, Sakai-ku, Sakai 590-0064, JapanDepartment of Gastroenterology, Osaka Rosai Hospital, 1179-3, Nagasone-cho, Kita-ku, Sakai 591-8025, JapanDepartment of Gastroenterology, Osaka Police Hospital, Kitayama-cho, Tennoji-ku, Osaka 543-0035, JapanDepartment of Gastroenterology, Sakai City Hospital, 1-1-1 Minamiyasui-cho, Sakai-ku, Sakai 590-0064, JapanDepartment of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Clinical Research Building (K1), 2-2 Yamadaoka, Suita, Osaka 565-0871, JapanDepartment of Gastroenterology, Itami City Hospital, 1-100 Koyaike, Itami-shi, Hyougo 664-8540, JapanDepartment of Gastroenterology, Osaka Kousei-Nenkin Hospital, 4-2-78 Fukushima, Fukushima-ku, Osaka 553-0003, JapanDepartment of Gastroenterology, Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-ku, Osaka 540-0006, JapanDepartment of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Clinical Research Building (K1), 2-2 Yamadaoka, Suita, Osaka 565-0871, JapanDepartment of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Clinical Research Building (K1), 2-2 Yamadaoka, Suita, Osaka 565-0871, JapanObjectives. Heparin replacement (HR) is often performed in patients with a high risk of thrombosis undergoing endoscopic procedures. However, information about the influence of HR is scarce. The aim of this study is to assess the clinical impact of HR for gastric endoscopic submucosal dissection (ESD). Methods. This is a retrospective study comprising approximately 1310 consecutive gastric neoplasms in 1250 patients, who underwent ESD in 5 institutes. We assessed the clinical findings and outcomes of ESD under HR, compared to ESD without HR as control. Results. A total of 24 EGC lesions in 24 patients were treated by ESD under HR. In the HR group, the complete en-bloc resection rate was 100%. The delayed bleeding rate was, however, higher in the HR group than in the controls (38% versus 4.6%). The timing of bleeding in the HR group was significantly later than in controls. In the control group, 209 patients discontinued antithrombotic therapy during perioperative period, and their delayed bleeding rate was not different from those without antithrombotic therapy (5.7% versus. 4.4%). A thromboembolic event was encountered in 1 patient under HR after delayed bleeding. Conclusion. ESD under HR is technically feasible but has a high risk of delayed bleeding.http://dx.doi.org/10.1155/2013/365830 |
| spellingShingle | Toshiyuki Yoshio Tsutomu Nishida Naoki Kawai Kiyonori Yuguchi Takuya Yamada Takamasa Yabuta Masato Komori Shinjiro Yamaguchi Shinji Kitamura Hideki Iijima Shusaku Tsutsui Tomoki Michida Eiji Mita Masahiko Tsujii Tetsuo Takehara Gastric ESD under Heparin Replacement at High-Risk Patients of Thromboembolism Is Technically Feasible but Has a High Risk of Delayed Bleeding: Osaka University ESD Study Group Gastroenterology Research and Practice |
| title | Gastric ESD under Heparin Replacement at High-Risk Patients of Thromboembolism Is Technically Feasible but Has a High Risk of Delayed Bleeding: Osaka University ESD Study Group |
| title_full | Gastric ESD under Heparin Replacement at High-Risk Patients of Thromboembolism Is Technically Feasible but Has a High Risk of Delayed Bleeding: Osaka University ESD Study Group |
| title_fullStr | Gastric ESD under Heparin Replacement at High-Risk Patients of Thromboembolism Is Technically Feasible but Has a High Risk of Delayed Bleeding: Osaka University ESD Study Group |
| title_full_unstemmed | Gastric ESD under Heparin Replacement at High-Risk Patients of Thromboembolism Is Technically Feasible but Has a High Risk of Delayed Bleeding: Osaka University ESD Study Group |
| title_short | Gastric ESD under Heparin Replacement at High-Risk Patients of Thromboembolism Is Technically Feasible but Has a High Risk of Delayed Bleeding: Osaka University ESD Study Group |
| title_sort | gastric esd under heparin replacement at high risk patients of thromboembolism is technically feasible but has a high risk of delayed bleeding osaka university esd study group |
| url | http://dx.doi.org/10.1155/2013/365830 |
| work_keys_str_mv | AT toshiyukiyoshio gastricesdunderheparinreplacementathighriskpatientsofthromboembolismistechnicallyfeasiblebuthasahighriskofdelayedbleedingosakauniversityesdstudygroup AT tsutomunishida gastricesdunderheparinreplacementathighriskpatientsofthromboembolismistechnicallyfeasiblebuthasahighriskofdelayedbleedingosakauniversityesdstudygroup AT naokikawai gastricesdunderheparinreplacementathighriskpatientsofthromboembolismistechnicallyfeasiblebuthasahighriskofdelayedbleedingosakauniversityesdstudygroup AT kiyonoriyuguchi gastricesdunderheparinreplacementathighriskpatientsofthromboembolismistechnicallyfeasiblebuthasahighriskofdelayedbleedingosakauniversityesdstudygroup AT takuyayamada gastricesdunderheparinreplacementathighriskpatientsofthromboembolismistechnicallyfeasiblebuthasahighriskofdelayedbleedingosakauniversityesdstudygroup AT takamasayabuta gastricesdunderheparinreplacementathighriskpatientsofthromboembolismistechnicallyfeasiblebuthasahighriskofdelayedbleedingosakauniversityesdstudygroup AT masatokomori gastricesdunderheparinreplacementathighriskpatientsofthromboembolismistechnicallyfeasiblebuthasahighriskofdelayedbleedingosakauniversityesdstudygroup AT shinjiroyamaguchi gastricesdunderheparinreplacementathighriskpatientsofthromboembolismistechnicallyfeasiblebuthasahighriskofdelayedbleedingosakauniversityesdstudygroup AT shinjikitamura gastricesdunderheparinreplacementathighriskpatientsofthromboembolismistechnicallyfeasiblebuthasahighriskofdelayedbleedingosakauniversityesdstudygroup AT hidekiiijima gastricesdunderheparinreplacementathighriskpatientsofthromboembolismistechnicallyfeasiblebuthasahighriskofdelayedbleedingosakauniversityesdstudygroup AT shusakutsutsui gastricesdunderheparinreplacementathighriskpatientsofthromboembolismistechnicallyfeasiblebuthasahighriskofdelayedbleedingosakauniversityesdstudygroup AT tomokimichida gastricesdunderheparinreplacementathighriskpatientsofthromboembolismistechnicallyfeasiblebuthasahighriskofdelayedbleedingosakauniversityesdstudygroup AT eijimita gastricesdunderheparinreplacementathighriskpatientsofthromboembolismistechnicallyfeasiblebuthasahighriskofdelayedbleedingosakauniversityesdstudygroup AT masahikotsujii gastricesdunderheparinreplacementathighriskpatientsofthromboembolismistechnicallyfeasiblebuthasahighriskofdelayedbleedingosakauniversityesdstudygroup AT tetsuotakehara gastricesdunderheparinreplacementathighriskpatientsofthromboembolismistechnicallyfeasiblebuthasahighriskofdelayedbleedingosakauniversityesdstudygroup |