The incidence of deep vein thrombosis in Japanese patients undergoing endoscopic submucosal dissection
| Autor: | Junro Hosaka, Ikuyo Takagi, Choitsu Sakamoto, Kazumasa Miyake, Nobue Ueki, Tomotaka Shindo, Tetsuro Kawagoe, Taku Tsukui, Katya Gudis, Masafumi Kusunoki, Seiji Futagami |
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| Rok vydání: | 2011 |
| Předmět: |
Male
medicine.medical_specialty Deep vein Single Center Fibrin Fibrinogen Degradation Products Stomach Neoplasms Gastroscopy medicine Humans Radiology Nuclear Medicine and imaging cardiovascular diseases Prospective cohort study Aged Ultrasonography Aged 80 and over Venous Thrombosis Univariate analysis Receiver operating characteristic business.industry Incidence (epidemiology) Gastroenterology Middle Aged medicine.disease Thrombosis Pulmonary embolism Surgery medicine.anatomical_structure ROC Curve Female Radiology Pulmonary Embolism business Biomarkers |
| Zdroj: | Gastrointestinal Endoscopy. 74:798-804 |
| ISSN: | 0016-5107 |
| DOI: | 10.1016/j.gie.2011.06.015 |
| Popis: | Background Endoscopic submucosal dissection (ESD) is more invasive than other common endoscopic procedures and may increase the risk for deep vein thrombosis (DVT)/pulmonary embolism. The incidence of DVT/pulmonary embolism after ESD has not been adequately studied. Objective To evaluate DVT incidence and disease-specific features of D-dimer levels in ESD patients. Design Prospective cohort study. Setting Single academic center. Patients This study involved 60 patients with superficial gastric neoplasms indicated for ESD. Intervention For all patients who underwent ESD, ultrasonography of the lower limbs was performed to detect DVT the day after ESD. D-dimer levels were measured 3 times: before ESD, immediately after ESD, and the day after ESD. Main Outcome Measurements DVT incidence after ESD. Results The DVT incidence was 10.0% (6/60). At all 3 time points, D-dimer measurements were higher in patients with DVT than in patients without DVT. According to receiver operating characteristic curve analysis, the resulting cut-off value of the D-dimer level the day after ESD was 1.9 μg/mL (sensitivity 83.3%; specificity 79.6%) for ESD patients, with superior association to pre-ESD or immediately after ESD. In univariate analyses, high D-dimer levels the day after ESD and the presence of comorbidities were significantly associated with DVT development. Limitations Single center and small number of patients. Conclusion ESD procedures have a moderate risk for venous thromboembolism. In patients undergoing ESD, D-dimer levels, especially on the day after ESD, may have specific features associated with DVT development. |
| Databáze: | OpenAIRE |
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