Risk factors for bleeding after endoscopic mucosal resection.
OBJECTIVE
To clarify the risk factors for bleeding after endoscopic mucosal resection (EMR).


METHODS
A total of 297 consecutive patients who underwent EMR were enrolled. Some of the patients had multiple lesions. Bleeding requiring endoscopic treatment was defined as bleeding after EMR. Odds ratios (OR) with 95% confidence intervals (CI), calculated by logistic regression with multivariate adjustments for covariates, were the measures of association.


RESULTS
Of the 297 patients, 57 (19.2%) patients with bleeding after EMR were confirmed. With multivariate adjustment, the cutting method of EMR, diameter, and endoscopic pattern of the tumor were associated with the risk of bleeding after EMR. The multivariate-adjusted OR for bleeding after EMR using endoscopic aspiration mucosectomy was 3.07 (95%CI, 1.59-5.92) compared with strip biopsy. The multiple-adjusted OR for bleeding after EMR for the highest quartile (16-50 mm) of tumor diameter was 5.63 (95%CI, 1.84-17.23) compared with that for the lowest (4-7 mm). The multiple-adjusted OR for bleeding after EMR for depressed type of tumor was 4.21 (95%CI, 1.75-10.10) compared with elevated type.


CONCLUSIONS
It is important to take tumor characteristics (tumor size and endoscopic pattern) and cutting method of EMR into consideration in predicting bleeding after EMR.
Shiba
Masatsugu
M
Department of Gastroenterology, Osaka City University Medical School, 1-4-3 Asahi-machi, Abeno-ku, Osaka 545-8585, Japan.
Higuchi
Kazuhide
K
Kadouchi
Kaori
K
Montani
Ai
A
Yamamori
Kazuki
K
Okazaki
Hirotoshi
H
Taguchi
Makiko
M
Wada
Tomoko
T
Itani
Atsushi
A
Watanabe
Toshio
T
Tominaga
Kazunari
K
Fujiwara
Yoshihiro
Y
Hayashi
Tomoshige
T
Tsumura
Kei
K
Arakawa
Tetsuo
T
D000368:Aged; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects* / Q000379:methods; D005753:Gastric Mucosa / Q000601:surgery; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D005773:Gastroscopy / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects; D015999:Multivariate Analysis; D019106:Postoperative Hemorrhage / Q000209:etiology*; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000601:surgery