Post-ESD endoscopy for prevention of delayed bleeding

Abstract

Objective To evaluate a second endoscopy for prevention of delayed bleeding after ESD. Methods Data of 67 patients with gastric epithelial neoplasms undergoing ESD from May to November 2011 were reviewed. The median age was 63 （31 ± 84） years. All patients were followed up by endoscopy on the first and the third day after ESD. Results Of 67 lesions, 5 were located at eardia, 6 at gastric body, 3 at fundus, 35 at antrum, 16 at gastric angle, and 2 at residual stomach. The mean maximum diameter of the lesions was 3.73 ±1.24 （2.0 ± 7.0 ）em. There were no intraoperative complications. Post-ESD de- layed bleeding was detected by endoscopy in 6 （9.0%） patients, with 5 on the third day and 1 on the fourth day. Forrest grading showed 2 cases of ] b, and 4 of 11 b. All 6 cases were cured by endoscopy. The inci- dence of postoperative bleeding was far more than that evaluated based on the patients＇ clinical manifestations only. But therapeutic effect and safety were the same according to the follow-up results. Conclusion Incidence of post-ESD bleeding is high, but there are no symptoms or severe consequences, so a second endoscopy after gastric ESD may contribute little to the prevention of delayed bleeding. Key words: Endoscopic submueosal dissection; Postoperative complications; Postoperative hemorrhage