Role of second-look endoscopy and prophylactic hemostasis after gastric endoscopic submucosal dissection: A systematic review and meta-analysis
- Authors
- Kim, Eun Hye; Park, Se Woo; Nam, Eunwoo; Eun, Chang Soo; Han, Dong Soo; Park, Chan Hyuk
- Issue Date
- Apr-2017
- Publisher
- WILEY
- Keywords
- endoscopic submucosal dissection; gastric neoplasm; hemostasis; prophylaxis; second-look endoscopy
- Citation
- JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, v.32, no.4, pp.756 - 768
- Indexed
- SCIE
SCOPUS
- Journal Title
- JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY
- Volume
- 32
- Number
- 4
- Start Page
- 756
- End Page
- 768
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/4257
- DOI
- 10.1111/jgh.13623
- ISSN
- 0815-9319
- Abstract
- Background: Although several studies have shown that second-look endoscopy does not affect the incidence of bleeding after gastric endoscopic submucosal dissection (ESD), the potential roles of second-look endoscopy have not been fully evaluated. This study aimed to determine the role of second-look endoscopy after ESD through a systematic review and meta-analysis.
Methods: This study conducted a systematic literature search of MEDLINE, EMBASE, and the Cochrane Library through March 2016 using the keywords "second-look," " prophylactic hemostasis," " prophylactic haemostasis," " prevention," " prophylaxis," and " endoscopic submucosal dissection." Studies were included if they evaluated the incidence of post-ESD bleeding according to second-look endoscopy or prophylactic hemostasis during second-look endoscopy.
Results: Four randomized controlled trials on post-ESD bleeding between second-look endoscopy and no second-look endoscopy and 12 non-randomized studies with a cohort design on post-ESD bleeding were included. On meta-analysis, second-look endoscopy did not affect delayed post-ESD bleeding (odds ratio [95% confidence interval] = 1.27 [0.80-2.00], I-2 = 0%). During second-look endoscopy, patients who were considered as high-risk for post-ESD bleeding underwent prophylactic hemostasis. Delayed post-ESD bleeding was more common in patients who were treated with hemostasis during second-look endoscopy compared with those who were not (odds ratio [ 95% confidence interval] = 3.40 [1.87-6.18], I-2 = 62%). In patients who underwent prophylactic hemostasis, the number needed to prolong a hospitalization period to avoid one additional post-ESD bleeding after discharge was 25.
Conclusion: Second-look endoscopy after ESD could not reduce the risk of delayed post-ESD bleeding. Delayed post-ESD bleeding was more common in patients who underwent prophylactic hemostasis than in those who did not.
- Files in This Item
-
Go to Link
- Appears in
Collections - 서울 의과대학 > 서울 내과학교실 > 1. Journal Articles
![qrcode](https://api.qrserver.com/v1/create-qr-code/?size=55x55&data=https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/4257)
Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.