Predictors of bleeding after endoscopic mucosal resection of gastric tumors.
BACKGROUND
Endoscopic mucosal resection has been increasingly used to treat gastric tumors. Bleeding is the major complication of endoscopic mucosal resection. This study evaluated risk factors for bleeding associated with endoscopic mucosal resection.


METHODS
Four hundred seventy-seven patients who underwent endoscopic mucosal resection of gastric tumors during the past 10 years were studied retrospectively. Bleeding encountered during endoscopic mucosal resection was termed immediate; bleeding after endoscopic mucosal resection was termed delayed. Univariate and multivariate analyses were used for determination of the factors related to delayed bleeding. One case of perforation was excluded.


RESULTS
Delayed bleeding occurred in 25 (5.3%) of 476 patients. The only factor found to be significantly different between cases with and without delayed bleeding was the occurrence of immediate bleeding during endoscopic mucosal resection (p < 0.001). Sites where immediate bleeding occurred were not the same as those where delayed bleeding arose. There were no significant differences in other factors.


CONCLUSIONS
When immediate bleeding occurs during endoscopic mucosal resection, there is an increased risk of delayed bleeding.
Okano
Akihiro
A
Department of Gastroenterology, Tenri Hospital, Nara, Japan.
Hajiro
Kiyoshi
K
Takakuwa
Hiroshi
H
Nishio
Akiyoshi
A
Matsushita
Mitsunobu
M
D000230:Adenocarcinoma / Q000601:surgery; D000236:Adenoma / Q000601:surgery; D000368:Aged; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000601:surgery*; D013997:Time Factors