Abstract
We report the current state of anticoagulation and antiplatelet therapy for post-procedure bleeding in 111 cases (esophagus, 4 cases ; stomach, 60 cases ; and colon, 47 cases) where endoscopic submucosal dissection (ESD) was performed in our hospital from April 2013 to March 2015. Post-procedure bleeding was defined as clinically evident bleeding that required emergency endoscopy and/or bleeding corresponding to the Forrest Ia or Ib classification. Post-procedure bleeding occurred in 8 cases (7.2% ; stomach, 6 and colon, 2 cases) , with 4 cases (stomach, 3 and colon, 1) taking antithrombotic drug，therefore, 16.7% of the cases on antithrombotic therapy experienced post-procedure bleeding. Post-procedure bleeding occurred in only 4 cases (4.6%, 4/87) without antithrombotic therapy. In the cases involving antithrombotic therapy, the post-procedure bleeding occurred on day 9 or later, but in the cases without antithrombotic therapy it occurred within 2 days from ESD. It is necessary to accumulate more data on the management of antithrombotic drugs. In this study, patients on antithrombotic therapy had a higher risk and slower onset of post-procedure bleeding, as reported in other studies. In our hospital, we empirically perform second look endoscopy on the day after ESD, but we should consider the timing of second look endoscopy in cases on antithrombotic therapy.
