Feasibility of gastric endoscopic submucosal dissection with continuous low-dose aspirin for patients receiving dual antiplatelet therapy

Autor: Kenji Hayasaka, Yasushi Katsuyama, Hideaki Harada, Satoshi Suehiro, Ryotaro Nakahara, Daisuke Murakami, Tetsuro Ujihara, Yuji Amano, Ryota Sagami, Takuya Nagasaka
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Male
medicine.medical_specialty
animal structures
Thienopyridine
Endoscopic Mucosal Resection
Postoperative Hemorrhage
Gastroenterology
03 medical and health sciences
0302 clinical medicine
Retrospective Study
Risk Factors
Stomach Neoplasms
Internal medicine
Gastroscopy
medicine
Humans
In patient
Aged
Retrospective Studies
Aged
80 and over
Aspirin
business.industry
Low-dose aspirin
Significant difference
Retrospective cohort study
Thrombosis
General Medicine
Endoscopic submucosal dissection
Postoperative bleeding
Middle Aged
Clopidogrel
Treatment Outcome
Gastric Mucosa
030220 oncology & carcinogenesis
Dual antiplatelet therapy
Practice Guidelines as Topic
Feasibility Studies
030211 gastroenterology & hepatology
Female
business
Gastrointestinal Hemorrhage
Platelet Aggregation Inhibitors
medicine.drug
Low dose aspirin
Zdroj: World Journal of Gastroenterology
ISSN: 2219-2840
1007-9327
Popis: Background Endoscopic submucosal dissection (ESD) for gastric neoplasms during continuous low-dose aspirin (LDA) administration is generally acceptable according to recent guidelines. This retrospective study aimed to investigate the effect of continuous LDA on the postoperative bleeding after gastric ESD in patients receiving dual antiplatelet therapy (DAPT). Aim To investigate the feasibility of gastric ESD with continuous LDA in patients with DAPT. Methods A total of 597 patients with gastric neoplasms treated with ESD between January 2010 and June 2017 were enrolled. The patients were categorized according to type of antiplatelet therapy (APT). Results The postoperative bleeding rate was 6.9% (41/597) in all patients. Patients were divided into the following two groups: no APT (n = 443) and APT (n = 154). APT included single-LDA (n = 95) and DAPT (LDA plus clopidogrel, n = 59) subgroups. In the single-LDA and DAPT subgroups, 56 and 39 patients were received continuous LDA, respectively. The bleeding rate with continuous single-LDA (10.7%) was similar to that with discontinuous single-LDA (10.3%) (P > 0.99). Although the bleeding rate with continuous LDA in patients receiving DAPT (23.1%) was higher than that with discontinuous LDA in patients receiving DAPT (5.0%), no significant difference was observed (P = 0.141). Conclusion The bleeding rate with continuous LDA in patients receiving DAPT was not statistically different from that with discontinuous LDA in patients receiving DAPT. Therefore, continuous LDA administration may be acceptable for ESD in patients receiving DAPT, although patients should be carefully monitored for possible bleeding.
Databáze: OpenAIRE
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