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| 1 | Risk factors for bleeding after endoscopic submucosal dissection of colorectal neoplasms显示文摘AIM:To investigate the risk factors for delayed bleeding following endoscopic submucosal dissection(ESD)treatment for colorectal neoplasms.METHODS:We retrospectively reviewed the medical records of 317 consecutive patients with 325 lesions who underwent ESD for superficial colorectal neoplasms at our hospital from January 2009 to June2013.Delayed post-ESD bleeding was defined as bleeding that resulted in overt hematochezia 6 h to 30d after ESD and the observation of bleeding spots as confirmed by repeat colonoscopy or a required blood transfusion.We analyzed the relationship between risk factors for delayed bleeding following ESD and the following factors using univariate and multivariate analyses:age,gender,presence of comorbidities,use of antithrombotic drugs,use of intravenous heparin,resected specimen size,lesion size,lesion location,lesion morphology,lesion histology,the device used,procedure time,and the presence of significant bleeding during ESD.RESULTS:Delayed post-ESD bleeding was found in14 lesions from 14 patients(4.3%of all specimens,4.4%patients).Patients with episodes of delayed postESD bleeding had a mean hemoglobin decrease of2.35 g/dL.All episodes were treated successfully using endoscopic hemostatic clips.Emergency surgery was not required in any of the cases.Blood transfusion was needed in 1 patient(0.3%).Univariate analysis revealed that lesions located in the cecum(P=0.012)and the presence of significant bleeding during ESD(P=0.024)were significantly associated with delayed post-ESD bleeding.The risk of delayed bleeding was higher for larger lesion sizes,but this trend was not statistically significant.Multivariate analysis revealed that lesions located in the cecum(OR=7.26,95%CI:1.99-26.55,P=0.003)and the presence of significant bleeding during ESD(OR=16.41,95%CI:2.60-103.68,P=0.003)were independent risk factors for delayed post-ESD bleeding.CONCLUSION:Location in the cecum and significant bleeding during ESD predispose patients to delayed post-procedural bleeding.Therefore,careful and additional management is recommended for these patients. | Sho Suzuki Akiko Chino Teruhito Kishihara Naoyuki Uragami Yoshiro Tamegai Takanori Suganuma Junko Fujisaki Masaaki Matsuura Takao Itoi Takuji Gotoda Masahiro Igarashi Fuminori Moriyasu | 2014 | World Journal of Gastroenterology2014，20，7： | 21 |
| 2 | A multicenter retrospective study of endoscopic resection for early gastric cancer显示文摘 | Ichiro Oda Daizo Saito Masahiro Tada Hiroyasu Iishi Satoshi Tanabe Tsuneo Oyama Toshihiko Doi Yoshihide Otani Junko Fujisaki Yoichi Ajioka Tsutomu Hamada Haruhiro Inoue Takuji Gotoda Shigeaki Yoshida | 2006 | Gastric Cancer2006，，4： | 6 |
| 3 | Incidence of lymph node metastasis and the feasibility of endoscopic resection for undifferentiated-type early gastric cancer显示文摘 | Toshiaki Hirasawa Takuji Gotoda Satoshi Miyata You Kato Tadakazu Shimoda Hirokazu Taniguchi Junko Fujisaki Takeshi Sano Toshiharu Yamaguchi | 2009 | Gastric Cancer2009，，3： | 5 |
| 4 | Incidence of lymph node metastasis and the feasibility of endoscopic resection for undifferentiated-type early gastric cancer显示文摘 | Toshiaki Hirasawa Takuji Gotoda Satoshi Miyata You Kato Tadakazu Shimoda Hirokazu Taniguchi Junko Fujisaki Takeshi Sano Toshiharu Yamaguchi | 2009 | Gastric Cancer2009，，3： | 3 |
| 5 | A multicenter retrospective study of endoscopic resection for early gastric cancer显示文摘 | Ichiro Oda Daizo Saito Masahiro Tada Hiroyasu Iishi Satoshi Tanabe Tsuneo Oyama Toshihiko Doi Yoshihide Otani Junko Fujisaki Yoichi Ajioka Tsutomu Hamada Haruhiro Inoue Takuji Gotoda Shigeaki Yoshida | 2006 | Gastric Cancer2006，，4： | 3 |
| 6 | Laparoscopic-endoscopic cooperative surgery for duodenal tumors: a unique procedure that helps ensure the safety of endoscopic submucosal dissection显示文摘 | Tomoyuki Irino Souya Nunobe Naoki Hiki Yorimasa Yamamoto Toshiaki Hirasawa Manabu Ohashi Junko Fujisaki Takeshi Sano Toshiharu Yamaguchi | 2014 | Endoscopy2014，，： | 2 |
| 7 | Clinical problems with antithrombotic therapy for endoscopic submucosal dissection for gastric neoplasms显示文摘Endoscopic submucosal dissection(ESD) is minimally invasive and thus has become a widely accepted treatment for gastric neoplasms,particularly for patients with comorbidities.Antithrombotic agents are used to prevent thrombotic events in patients with comorbidities such as cardio-cerebrovascular diseases and atrial fibrillation.With appropriate cessation,antithrombotic therapy does not increase delayed bleeding in low thrombosis-risk patients.However,high thrombosisrisk patients are often treated with combination therapy with antithrombotic agents and occasionally require the continuation of antithrombotic agents or heparin bridge therapy(HBT) in the perioperative period.Dual antiplatelet therapy(DAPT),a representative combination therapy,is frequently used after placement of drug-eluting stents and has a high risk of delayed bleeding.In patients receiving DAPT,gastric ESD may be postponed until DAPT is no longer required.HBT is often required for patients treated with anticoagulants and has an extremely high bleeding risk.The continuous use of warfarin or direct oral anticoagulants may be possible alternatives.Here,we show that some antithrombotic therapies in high thrombosis-risk patients increase delayed bleeding after gastric ESD,whereas most antithrombotic therapies do not.The management of high thrombosis-risk patients is crucial for improved outcomes. | Toshiyuki Yoshio Tsutomu Nishida Yoshito Hayashi Hideki Iijima Masahiko Tsujii Junko Fujisaki Tetsuo Takehara | 2016 | World Journal of Gastrointestinal Endoscopy2016，8，20： | 2 |
| 8 | Clinical characterization of gastric lesions initially diagnosed as low‐grade adenomas on forceps biopsy显示文摘 | Akiyoshi Kasuga Yorimasa Yamamoto Junko Fujisaki Kazuhisa Okada Masami Omae Akiyoshi Ishiyama Toshiaki Hirasawa Akiko Chino Tomohiro Tsuchida Masahiro Igarashi Etsuo Hoshino Noriko Yamamoto Minoru Kawaguchi Rikiya Fujita | 2012 | Digestive Endoscopy2012，，5： | 2 |
| 9 | Therapeutic outcomes of endoscopic resection for superficial non‐ampullary duodenal tumor显示文摘 | Yorimasa Yamamoto Natsuko Yoshizawa Hideomi Tomida Junko Fujisaki Masahiro Igarashi | 2014 | Digestive Endoscopy2014，，： | 2 |
| 10 | Lymph node metastasis from undifferentiated-type mucosal gastric cancer satisfying the expanded criteria for endoscopic resection based on routine histological examination显示文摘 | Toshiaki Hirasawa Junko Fujisaki Tetsu Fukunaga Yorimasa Yamamoto Toshiharu Yamaguchi Masamichi Katori Noriko Yamamoto | 2010 | Gastric Cancer2010，，4： | 1 |
| 11 | Incidence of lymph node metastasis and the feasibility of endoscopic resection for undifferentiated-type early gastric cancer显示文摘 | Toshiaki Hirasawa Takuji Gotoda Satoshi Miyata You Kato Tadakazu Shimoda Hirokazu Taniguchi Junko Fujisaki Takeshi Sano Toshiharu Yamaguchi | 2009 | Gastric Cancer2009，，3： | 1 |
| 12 | Lymph node metastasis from undifferentiated-type mucosal gastric cancer satisfying the expanded criteria for endoscopic resection based on routine histological examination显示文摘 | Toshiaki Hirasawa Junko Fujisaki Tetsu Fukunaga Yorimasa Yamamoto Toshiharu Yamaguchi Masamichi Katori Noriko Yamamoto | 2010 | Gastric Cancer2010，，4： | 1 |
| 13 | Incidence of lymph node metastasis and the feasibility of endoscopic resection for undifferentiated-type early gastric cancer显示文摘 | Toshiaki Hirasawa Takuji Gotoda Satoshi Miyata You Kato Tadakazu Shimoda Hirokazu Taniguchi Junko Fujisaki Takeshi Sano Toshiharu Yamaguchi | 2009 | Gastric Cancer2009，，3： | 1 |
| 14 | A clinicopathological study of gastric stump carcinoma following proximal gastrectomy显示文摘 | Shigekazu Ohyama Masanori Tokunaga Naoki Hiki Tetsu Fukunaga Junko Fujisaki Yasuyuki Seto Toshiharu Yamaguchi | 2009 | Gastric Cancer2009，，2： | 1 |
| 15 | Incidence of lymph node metastasis and the feasibility of endoscopic resection for undifferentiated-type early gastric cancer显示文摘 | Toshiaki Hirasawa Takuji Gotoda Satoshi Miyata You Kato Tadakazu Shimoda Hirokazu Taniguchi Junko Fujisaki Takeshi Sano Toshiharu Yamaguchi | 2009 | Gastric Cancer2009，，3： | 1 |
| 16 | A multicenter retrospective study of endoscopic resection for early gastric cancer显示文摘 | Ichiro Oda Daizo Saito Masahiro Tada Hiroyasu Iishi Satoshi Tanabe Tsuneo Oyama Toshihiko Doi Yoshihide Otani Junko Fujisaki Yoichi Ajioka Tsutomu Hamada Haruhiro Inoue Takuji Gotoda Shigeaki Yoshida | 2006 | Gastric Cancer2006，，4： | 1 |
| 17 | A multicenter retrospective study of endoscopic resection for early gastric cancer显示文摘 | Ichiro Oda Daizo Saito Masahiro Tada Hiroyasu Iishi Satoshi Tanabe Tsuneo Oyama Toshihiko Doi Yoshihide Otani Junko Fujisaki Yoichi Ajioka Tsutomu Hamada Haruhiro Inoue Takuji Gotoda Shigeaki Yoshida | 2006 | Gastric Cancer2006，，4： | 1 |
| 18 | Incidence of lymph node metastasis and the feasibility of endoscopic resection for undifferentiated-type early gastric cancer显示文摘 | Toshiaki Hirasawa Takuji Gotoda Satoshi Miyata You Kato Tadakazu Shimoda Hirokazu Taniguchi Junko Fujisaki Takeshi Sano Toshiharu Yamaguchi | 2009 | Gastric Cancer2009，，3： | 1 |
| 19 | A multicenter retrospective study of endoscopic resection for early gastric cancer显示文摘 | Ichiro Oda Daizo Saito Masahiro Tada Hiroyasu Iishi Satoshi Tanabe Tsuneo Oyama Toshihiko Doi Yoshihide Otani Junko Fujisaki Yoichi Ajioka Tsutomu Hamada Haruhiro Inoue Takuji Gotoda Shigeaki Yoshida | 2006 | Gastric Cancer2006，，4： | 1 |
| 20 | A multicenter retrospective study of endoscopic resection for early gastric cancer显示文摘 | Ichiro Oda Daizo Saito Masahiro Tada Hiroyasu Iishi Satoshi Tanabe Tsuneo Oyama Toshihiko Doi Yoshihide Otani Junko Fujisaki Yoichi Ajioka Tsutomu Hamada Haruhiro Inoue Takuji Gotoda Shigeaki Yoshida | 2006 | Gastric Cancer2006，，4： | 1 |
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