Timing of bleeding and thromboembolism associated with endoscopic submucosal dissection for gastric cancer in Japan.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Shiroma Sho, Hatta Waku, Tsuji Yosuke, Yoshio Toshiyuki, Yabuuchi Yohei, Hoteya Shu, Tsuji Shigetsugu, Nagami Yasuaki, Hikichi Takuto, Kobayashi Masakuni, Morita Yoshinori, Sumiyoshi Tetsuya, Iguchi Mikitaka, Tomida Hideomi, Inoue Takuya, Mikami Tatsuya, Hasatani Kenkei, Nishikawa Jun, Matsumura Tomoaki, Nebiki Hiroko, Nakamatsu Dai, Ohnita Ken, Suzuki Haruhisa, Ueyama Hiroya, Hayashi Yoshito, Sugimoto Mitsushige, Yamaguchi Shinjiro, Michida Tomoki, Yada Tomoyuki, Asahina Yoshiro, Narasaka Toshiaki, Kuribayashi Shiko, Kiyotoki Shu, Mabe Katsuhiro, Fujishiro Mitsuhiro, Masamune Atsushi, Fujisaki Junko
Аннотация
METHODS: We retrospectively reviewed 10,320 patients who underwent ESD for EGC during November 2013-October 2016. We evaluated overall bleeding rates and their inter-group differences. Factors associated with early/late (cut-off 5 days) bleeding and thromboembolism frequency and its association with the intake of antithrombotic agents were investigated.
RESULTS: Overall, the post-ESD bleeding rate was 4.7% (489/10 320); the median time to post-ESD bleeding was 4 days. The post-ESD bleeding rates were 3.2%, 8.7%, 15.5%, and 29.9% in those not taking antithrombotic agents, those taking antiplatelet agents, those taking anticoagulants (ACs), and those taking antiplatelet agents and ACs. Warfarin (odds ratio [OR], 9.16), direct oral ACs (OR, 4.16), chronic kidney disease with hemodialysis (OR, 2.93), thienopyridine (OR, 2.25), aspirin (OR, 1.66), tumor size >30 mm (OR, 1.86), multiple tumors' resection (OR, 1.54), and tumor in the lower third of the stomach (OR, 1.40) were independent risk factors for early bleeding. The independent risk factors for late bleeding were direct oral ACs (OR, 7.42), chronic kidney disease with hemodialysis (OR, 4.99), warfarin (OR, 3.90), thienopyridine (OR, 3.09), liver cirrhosis (OR, 2.43), cilostazol (OR, 1.93), aspirin (OR, 1.92), ischemic heart disease (OR, 1.77), and male sex (OR, 1.65). There were three (0.03%) thromboembolic events (cerebral infarction = 2, transient ischemic attack = 1).
CONCLUSION: We revealed the timing of bleeding and risk factors for early/late bleeding and showed the thromboembolism frequency associated with ESD for EGC.