Effect of Antithrombotic Therapy and Long Endoscopic Submucosal Dissection Procedure Time on Early and Delayed Postoperative Bleeding

Digestion ◽  
2017 ◽  
Vol 96 (1) ◽  
pp. 21-28 ◽  
Author(s):  
Nobue Ueki ◽  
Seiji Futagami ◽  
Teppei Akimoto ◽  
Yuta Maruki ◽  
Hiroshi Yamawaki ◽  
...  
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Antithrombotic Therapy ◽  
Postoperative Bleeding ◽  
Procedure Time ◽  
Submucosal Dissection

scholarly journals A Novel Technique of Endoscopic Papillectomy with Hybrid Endoscopic Submucosal Dissection for Ampullary Tumors: A Proof-of-Concept Study (with Video)

2020 ◽  
Vol 9 (8) ◽  
pp. 2671
Author(s):  
Naminatsu Takahara ◽  
Yosuke Tsuji ◽  
Yousuke Nakai ◽  
Yukari Suzuki ◽  
Akiyuki Inokuma ◽  
...  
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Demographic Data ◽  
Postoperative Bleeding ◽  
Incomplete Resection ◽  
Proof Of Concept ◽  
Procedure Time ◽  
Concept Study ◽  
Submucosal Dissection ◽  
Endoscopic Papillectomy ◽  
Ampullary Tumors

Background: Endoscopic papillectomy (EP) carries a potential risk of procedure-related adverse events and incomplete resection. Since hybrid endoscopic submucosal dissection (ESD) had been established as an alternative option for relatively large and difficult gastrointestinal tumors, we evaluated a novel EP with hybrid ESD (hybrid ESD-EP) for curative safe margin in this proof-of-concept study. Methods: A total of eight cases who underwent hybrid ESD-EP between 2018 and 2020 were identified from our prospectively maintained database. Hybrid ESD-EP involved a (sub)circumferential incision with partial submucosal dissection, and subsequent snare resection of ampullary tumors, which was performed by two endoscopists with expertise in ESD or endoscopic retrograde cholangiopancreatography. Demographic data and clinicopathological outcomes were retrospectively evaluated. Results: En bloc resection was achieved by hybrid ESD-EP in all eight cases, with the median procedure time of 112 (range: 65–170) minutes. The median diameters of the resected specimens and tumors were 18 and 12 mm, respectively. All lateral margins were clear, whereas vertical margin was uncertain in three (38%), resulting in the complete resection rate of 63%. Postoperative bleeding and pancreatitis developed in each one (13%). No tumor recurrence was observed even in those cases with uncertain vertical margin, after a median follow-up of 244 (range, 97–678) days. Conclusions: Hybrid ESD-EP seems to be feasible and promising in ensuring the lateral resection margin. However, further investigations, especially to secure the vertical margin and to shorten the procedure time, should be required.

scholarly journals Postoperative bleeding after gastric endoscopic submucosal dissection in patients receiving antithrombotic therapy

2016 ◽  
Vol 20 (1) ◽  
pp. 207-214 ◽  
Author(s):  
Tsukasa Furuhata ◽  
Mitsuru Kaise ◽  
Shu Hoteya ◽  
Toshiro Iizuka ◽  
Akihiro Yamada ◽  
...  
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Antithrombotic Therapy ◽  
Postoperative Bleeding ◽  
Submucosal Dissection

scholarly journals Postoperative bleeding in patients on antithrombotic therapy after gastric endoscopic submucosal dissection

2017 ◽  
Vol 23 (30) ◽  
pp. 5557 ◽  
Author(s):  
Chiko Sato ◽  
Kingo Hirasawa ◽  
Ryonho Koh ◽  
Ryosuke Ikeda ◽  
Takehide Fukuchi ◽  
...  
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Antithrombotic Therapy ◽  
Postoperative Bleeding ◽  
Submucosal Dissection

scholarly journals Acceptability of endoscopic submucosal dissection for sessile serrated lesions: comparison with non-sessile serrated lesions

2020 ◽  
Vol 08 (12) ◽  
pp. E1832-E1839
Author(s):  
Yuichiro Kuroki ◽  
Toshiyuki Endo ◽  
Kenta Iwahashi ◽  
Naoki Miyao ◽  
Reika Suzuki ◽  
...  
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Postoperative Bleeding ◽  
En Bloc Resection ◽  
Tumor Location ◽  
Proximal Colon ◽  
R0 Resection ◽  
Resection Rate ◽  
En Bloc ◽  
Submucosal Dissection ◽  
Serrated Lesions

Abstract Background and study aims Sessile serrated lesions (SSL) are major precursor lesions of serrated pathway cancers, and appropriate treatment may prevent interval colorectal cancer. Studies have reported the outcomes of endoscopic mucosal resection (EMR) for SSL; however, there are insufficient reports on endoscopic submucosal dissection (ESD). We examined the characteristics and outcomes of SSL and compared them to those of non-SSL in ESD. Patients and methods We reviewed 370 consecutive cases in 322 patients who underwent colorectal ESD between January 2016 and March 2020 at our hospital. There were 267 0-IIa lesions that were stratified into 41 SSL and 226 non-SSL (intramucosal cancer, adenoma) cases. We used propensity matching to adjust for the variances in the factors affecting treatment between the SSL and non-SSL groups. Results In the baseline cases, young women and proximal colon tumor location were significantly more common in the SSL group. There were no statistically significant differences between the SSL and non-SSL groups in terms of en bloc resection rate (97.6 % vs. 99.6 %; P = 0.28), R0 resection rate (92.7 % vs. 93.4 %; P = 0.74), perforation (0 % vs. 0.9 %; P > 0.99), and postoperative bleeding (2.4 % vs. 1.8 %; P = 0.56). Thirty-eight pairs were matched using propensity score, and the median dissection speed (12 vs. 7.7 cm2/h; P = 0.0095) was significantly faster in the SSL than in the non-SSL group. Conclusions ESD for SSL was safely performed, and SSL was smoother to remove than non-SSL. ESD might be an acceptable endoscopic treatment option for SSL.

Should antithrombotic therapy be stopped in patients undergoing gastric endoscopic submucosal dissection?

2016 ◽  
Vol 31 (4) ◽  
pp. 1746-1753 ◽  
Author(s):  
Kimihiro Igarashi ◽  
Kohei Takizawa ◽  
Naomi Kakushima ◽  
Masaki Tanaka ◽  
Noboru Kawata ◽  
...  
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Antithrombotic Therapy ◽  
Submucosal Dissection
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