Second-look endoscopy is not associated with better clinical outcomes after gastric endoscopic submucosal dissection: a prospective, randomized, clinical trial analyzed on an as-treated basis - 17/07/13
Résumé |
Background |
The efficacy of routine second-look endoscopy (SLE) to detect or prevent bleeding after gastric endoscopic submucosal dissection (ESD) has not yet been validated.
Objective |
The aim of this study was to determine whether SLE affects clinical outcomes including bleeding and morbidity after gastric ESD.
Design |
A prospective, randomized, controlled study with consecutive data analyzed on an as-treated basis.
Setting |
A single, tertiary-care referral center.
Patients |
A total of 182 patients.
Intervention |
Gastric ESD and SLE.
Main Outcome Measurements |
Incidence of and risk factors related to bleeding after ESD and outcomes by univariate or multivariate analysis.
Results |
Among 182 patients enrolled, 74 and 81 patients were assigned to the SLE and no-SLE groups, respectively. Two groups were observed closely for 4 weeks. Bleeding occurred after ESD in 21 patients (13.5%). Hemoglobin loss (≥2.0 g/dL) was observed in 20 patients, and melena developed in 1 patient after ESD. However, only 1 patient needed a transfusion. Twelve patients (16.2%) in the SLE group and 9 in the no-SLE group (11.1%) experienced bleeding after ESD. The frequency of bleeding after ESD was not significantly different between the 2 groups (P = .66). There were no risk factors related to bleeding after ESD.
Limitations |
Single-center analysis.
Conclusion |
SLE is not routinely necessary because it does not affect clinical outcomes, including bleeding and morbidity after ESD. (Clinical trial registration number: KCT0000146.)
Le texte complet de cet article est disponible en PDF.Abbreviations : APC, aPTT, ESD, PT, SLE
Plan
| DISCLOSURE: This research was supported by the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Education, Science and Technology (2012-0004734) and Chong Kun Dang Pharmaceutical Corporation. No other financial relationships relevant to this publication were disclosed. |
|
| If you would like to chat with an author of this article, you may contact Dr Kim at hyskim@yonsei.ac.kr. |
Vol 78 - N° 2
P. 285-294 - août 2013 Retour au numéro
Article précédent
- Individualization of metal stents for management of gastric outlet obstruction caused by distal stomach cancer: a prospective study
- Ding Shi, Yin-su Bao, Yong-pan Liu
- Metabolomic-derived novel cyst fluid biomarkers for pancreatic cysts: glucose and kynurenine
- Walter G. Park, Manhong Wu, Raffick Bowen, Ming Zheng, William L. Fitch, Reetesh K. Pai, Dariusz Wodziak, Brendan C. Visser, George A. Poultsides, Jeff A. Norton, Subhas Banerjee, Ann M. Chen, Shai Friedland, Brennan A. Scott, Pankaj Jay Pasricha, Anson W. Lowe, Gary Peltz
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?