Risk factors for esophageal delayed bleeding after endoscopic submucosal dissection of early esophageal carcinoma and precancerous lesions

Abstract

Objective To identify the possible risk factors for esophageal delayed bleeding after endoscopic submucosal dissection(ESD) of early esophageal carcinoma and precancerous lesions. Methods Data of 281 patients with early esophageal carcinoma and precancerous lesions treated by ESD were reviewed. Risk factors for esophageal delayed bleeding were investigated by univariate analysis and logistic multivariable regression analysis. Results Esophageal delayed bleeding occurred in 22 patients(7.83%). Univariate analysis showed there was significant difference between delayed bleeding group and non-delayed bleeding group in regard of age(P=0.046), lesion size(P=0.013), and lesion infiltration depth(P<0.001). Together with three factors above, the intraoperative bleeding(P=0.068) was also analyzed by Logistic multivariable regression analysis which showed only infiltration depth was the independent risk factor of early esophageal carcinoma and precancerous lesions treated by ESD(P=0.002, OR=6.88, 95%CI: 1.07-39.28). Conclusion Patients older than 60 years and diameters more than 3 cm might be prone to delayed bleeding, but the direct factor is infiltration depth. The deeper lesions infiltrate, the delayed bleeding is more likely to occur. Key words: Esophageal carcinoma; Precancerous conditions; Endoscopic submucosal dissection; Delayed bleeding