Risk factors for delayed postendoscopic mucosal resection hemorrhage in patients with gastric tumor

• DOI: 10.1097/meg.0b013e32801015be
• Publication Date: 2007-04-04T08:03:10Z
• Authors: Jae Woo Kim; Hyun Soo Kim; Dong Hoon Park; Yong Soon Park; Myeong Gwan Jee; Soon Koo Baik; Sang Ok Kwon; Dong Ki Lee
• Keywords: Endoscopic mucosal resection; Melena

Although endoscopic mucosal resection has been recognized as the standard treatment for gastric neoplasm, postendoscopic hemorrhage remains a major complication of resection, and this problem seems to be increasing owing development invasive techniques. The aims study were determine incidence grade identify risk factors delayed in patients with neoplasm.Data resections performed by three endoscopists retrospectively collected over 8 years then analyzed. Immediate was defined bleeding during procedure. Delayed when two four following parameters satisfied after period; (i) hematemesis, melena or dizziness, (ii) hemoglobin loss >2 g/dl, (iii) blood pressure decrease >20 mmHg pulse rate increase >20/min (iv) Forrest I IIa-IIb on follow-up endoscopy.A total 157 (mean age: 64 years, male : female=44 113) reviewed. Twenty-nine (18.5%) 13 (8.3%) presented immediate hemorrhage, respectively. Multivariate logistic regression analysis revealed that patient's age (<or=65 years; odds ratio 6.11, 95% confidence interval 1.12-33.43), size lesion (>15 mm; 5.90, 1.13-30.87) experience endoscopist (<or=5 16.31, 1.46-181.97) significantly predictive variables hemorrhage.Considering higher careful preparation close monitoring are required who less than 65 have large lesions 15 mm if procedures an inexperienced endoscopist.