Document Detail


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.
MedLine Citation:
PMID:  23531425     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.).
Authors:
Ho Yoel Ryu; Jae Woo Kim; Hyun-Soo Kim; Hong Jun Park; Hyo Keun Jeon; So Yeon Park; Bo Ra Kim; Cui Cui Lang; Sung Ho Won
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2013-03-24
Journal Detail:
Title:  Gastrointestinal endoscopy     Volume:  78     ISSN:  1097-6779     ISO Abbreviation:  Gastrointest. Endosc.     Publication Date:  2013 Aug 
Date Detail:
Created Date:  2013-07-22     Completed Date:  2014-03-10     Revised Date:  2014-07-31    
Medline Journal Info:
Nlm Unique ID:  0010505     Medline TA:  Gastrointest Endosc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  285-94     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Adenocarcinoma / surgery*
Aged
Dissection / methods
Female
Gastric Mucosa / surgery*
Gastroscopy / methods*
Humans
Male
Middle Aged
Postoperative Hemorrhage / diagnosis*,  prevention & control
Second-Look Surgery / methods*
Stomach Neoplasms / surgery*
Tertiary Care Centers
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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