关键词: 内镜下黏膜剥离术, 危险因素, 早期胃癌, 术后, 出血

Abstract:

Objective To investigate the influencing factors of bleeding after endoscopic submucosal

dissection (ESD) in early gastric cancer and precancerous lesions, and to conduct risk-stratification.

Methods During January 2016 to December 2020, 237 cases which experienced ESD surgery owing to

early gastric cancer and precancerous lesions were collected in Qingdao Municipal Hospital Affiliated

to Qingdao University. These cases were used to analyse influencing factors of bleeding after ESD.

Additionally, influencing factors was scored and stratified into high-risk, intermediate-risk, and low-risk.

Results 13 patients with early gastric cancer were bled after ESD, with an incidence of 4.5%. The size

of resecting lesions, pathological changes ≥ 2 lesions, the gastric ulcer history, the cirrhosis history, the

therioma history, aspirin using history, clopidogrel using history, and dual antiplatelet therapy history

were identified as influencing factors of bleeding after ESD by univariate analysis. Nevertheless, only

gastric ulcer history, the size of resecting lesions, the therioma history, and dual antiplatelet therapy history were identified has a close relation with bleeding after ESD by multivariate Analysis. Conclusion

Gastric ulcer history, the size of resecting lesions, therioma history, and dual antiplatelet therapy history

are independent risk factor of bleeding after ESD. For patients with multiple risk factors, preoperative

evaluation, intraoperative caution, and postoperative observation can effectively prevent postoperative

bleeding.

Key words: Endoscopic submucosal dissection, Risk factor, Early gastric cancer, Postoperative, Bleeding