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Clinical features and predictive factors of coagulation syndrome after endoscopic submucosal dissection for early gastric neoplasm.

Authors
 Hyuk Lee  ;  Kyung Seok Cheoi  ;  Hyunsoo Chung  ;  Jun Chul Park  ;  Sung Kwan Shin  ;  Sang Kil Lee  ;  Yong Chan Lee 
Citation
 Gastric Cancer, Vol.15(1) : 83-90, 2012 
Journal Title
 Gastric Cancer 
ISSN
 1436-3291 
Issue Date
2012
MeSH
Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents/therapeutic use ; Blood Coagulation Disorders/epidemiology ; Blood Coagulation Disorders/etiology* ; Blood Coagulation Disorders/pathology ; Dissection/adverse effects* ; Dissection/methods ; Endoscopy/adverse effects* ; Endoscopy/methods ; Female ; Gastric Mucosa/surgery ; Humans ; Incidence ; Male ; Middle Aged ; Multivariate Analysis ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms/pathology ; Stomach Neoplasms/surgery* ; Time Factors
Keywords
Endoscopic submucosal dissection ; Coagulation syndrome ; Complication ; Gastric neoplasm
Abstract
BACKGROUND: Various endoscopic submucosal dissection (ESD)-related complications, such as perforation or bleeding, occur frequently. However, the clinical course of coagulation syndrome (CS) after ESD is not known. The aim of this study was to clarify the clinical outcomes and predictive factors of CS after ESD for early gastric lesions. METHODS: ESD procedures were performed in the typical sequence (marking, incision, and submucosal dissection). Four hundred and ninety-five patients with early gastric neoplasms were classified into two groups based on their clinical course after ESD: one group with post-ESD CS and the other with a normal clinical course. The clinical outcomes of the CS group were analyzed, and various clinical and pathological factors related to post-ESD CS were investigated using univariate and multivariate analyses. RESULTS: Coagulation syndrome occurred after ESD in 35 patients. In the CS group, the median period of inflammatory symptoms was 23.7 ± 12.0 h, and no blood cultures showed bacteremia. Multivariate analysis demonstrated that a tumor size of more than 1.5 cm [odds ratio (OR) 5.99, P < 0.001], tumor location in the middle third of the stomach (OR 2.84, P = 0.005), and a procedural time longer than 45 min (OR 2.71, P = 0.033) were independent risk factors for this complication. All patients with CS presented with a favorable outcome, irrespective of antibiotic treatment. CONCLUSIONS: This study suggests that CS occurs with an incidence of 7.1% after ESD for gastric lesions, and the factors associated with post-ESD CS include tumor size and location, and procedural duration.
Full Text
http://link.springer.com/article/10.1007%2Fs10120-011-0073-x
DOI
21761134
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Park, Jun Chul(박준철) ORCID logo https://orcid.org/0000-0001-8018-0010
Shin, Sung Kwan(신성관) ORCID logo https://orcid.org/0000-0001-5466-1400
Lee, Sang Kil(이상길) ORCID logo https://orcid.org/0000-0002-0721-0364
Lee, Yong Chan(이용찬) ORCID logo https://orcid.org/0000-0001-8800-6906
Lee, Hyuk(이혁)
Cheoi, Kyung Seok(최경석)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/90300
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