Bleeding after endoscopic submucosal dissection of gastric lesions

J Dig Dis. 2020 Mar;21(3):139-146. doi: 10.1111/1751-2980.12850.

Abstract

Endoscopic submucosal dissection (ESD) is generally used to treat gastric mucosal and submucosal lesions. Nevertheless, ESD is more difficult and complicated to perform than a traditional endoscopic mucosal resection, which can increase the incidence of various complications including hemorrhage, perforation and infection. Hemorrhage is a major post-ESD complication. Prevention and early diagnosis of post-ESD bleeding for gastric lesions are closely associated with the efficacy and safety of the operation. Many studies have reported the risks of and the preventative measures for hemorrhage after gastric ESD, but there remain some issues to be solved. We thus reviewed the risk factors, precautions and treatments for hemorrhage after ESD of gastric lesions.

Keywords: endoscopic submucosal dissection; gastric lesion; hemorrhage; risk factors.

Publication types

  • Review

MeSH terms

  • Endoscopic Mucosal Resection / adverse effects*
  • Fibrinolytic Agents / adverse effects
  • Gastric Mucosa / blood supply*
  • Gastric Mucosa / surgery
  • Hemostasis, Surgical / methods*
  • Humans
  • Postoperative Hemorrhage / etiology*
  • Postoperative Hemorrhage / therapy
  • Renal Dialysis / adverse effects
  • Renal Insufficiency, Chronic / complications
  • Risk Factors
  • Stomach Neoplasms / complications
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / surgery*
  • Tumor Burden

Substances

  • Fibrinolytic Agents