Is a second-look endoscopy necessary after endoscopic submucosal dissection for gastric neoplasm?

Content Provider	Europe PMC
Author	Kim, Eun Ran Kim, Jung Ha Kang, Ki Joo Min, Byung-Hoon Lee, Jun Haeng Rhee, Poong-Lyul Rhee, Jong Chul Kim, Jae J.
Copyright Year	2015
Abstract	Background/AimsSecond-look endoscopy is performed to check for the possibility of post-endoscopic submucosal dissection (ESD) bleeding and to perform prophylactic hemostasis in most hospitals; however, there is little evidence about the efficacy of second-look endoscopy. We investigated whether second-look endoscopy after ESD is useful in the prevention of post-ESD bleeding.MethodsA total of 550 lesions with gastric epithelial neoplasms in 502 patients (372 men and 130 women) were treated with ESD between August 18, 2009 and August 18, 2010. After the exclusion of three lesions of post-ESD bleeding within 24 hours, 547 lesions (335 early gastric cancers and 212 gastric adenomas) were included for the final analysis.ResultsThe occurrence rate of delayed post-ESD bleeding was not significantly different between the second-look group and the no second-look group (1% vs 2.5%, p>0.05). The only predictor of delayed bleeding was tumor size, regardless of second-look endoscopy after ESD (22.8±9.87 vs 15.1±10.47, p<0.05). There was no difference between the prophylactic hemostasis and nonprophylactic hemostasis groups, including the occurrence rate of delayed bleeding. In the second-look group with prophylactic hemostasis, the hospital stay was more prolonged than in the second-look group without prophylactic hemostasis, but there was no significant difference (p=0.08).ConclusionsSecond-look endoscopy to prevent delayed bleeding after ESD provides no significant medical benefits.
ISSN	19762283
Journal	Gut and Liver
Volume Number	9
PubMed Central reference number	PMC4282857
Issue Number	1
PubMed reference number	25071070
e-ISSN	20051212
DOI	10.5009/gnl13422
Language	English
Publisher	Gut and Liver
Publisher Date	2015-01-01
Access Restriction	Open
Rights License	This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright © 2015 by The Korean Society of Gastroenterology, the Korean Society of Gastrointestinal Endoscopy, the Korean Society of Neurogastroenterology and Motility, Korean College of Helicobacter and Upper Gastrointestinal Research, Korean Association for the Study of Intestinal Diseases, the Korean Association for the Study of the Liver, Korean Pancreatobiliary Association, and Korean Society of Gastrointestinal Cancer.
Subject Keyword	Second-look endoscopy Endoscopic submucosal dissection Delayed bleeding Prophylactic hemostasis
Content Type	Text
Resource Type	Article
Subject	Hepatology Gastroenterology