2016 Volume 36 Issue 5 Pages 883-888
Background: Endoscopic procedures beyond a simple biopsy were started in January 2013, in accordance with the guidelines for gastroenterological endoscopy in patients on antithrombotic therapy (issued in July 2012). Patients and Methods: Between January 2013 and October 2014, 730 patients on oral antithrombotic therapy underwent endoscopy (upper gastrointestinal endoscopy, 431 patients; lower gastrointestinal endoscopy, 299 patients). Of these 730 patients, the post-endoscopic rate of significant bleeding was investigated in 216 patients who underwent endoscopic procedures beyond a simple biopsy. Results: The average age was 74.1 years, and the male-to-female ratio was 2:1. The post-endoscopy bleeding rate was 0% (0/165) in patients who underwent biopsy, 0% (0/17) in patients who underwent endoscopic mucosal resection (EMR), and 30% (3/10) in patients who underwent endoscopic submucosal dissection (ESD). The post-endoscopy bleeding rate after gastric ESD was significantly higher in the patient group on oral antithrombotic medications than in that not taking such medications (P<0.0001). There were no cases of thromboembolism. Conclusion: Clinicians should be cautious when performing endoscopic procedures beyond a simple biopsy, in compliance with the above guidelines, as the rate of post-ESD bleeding is high in patients taking oral antithrombotic medications, including those who have been restarted on antithrombotic treatment.
