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논문KCI 등재

Preventing and Controlling Bleeding in Gastric Endoscopic Submucosal Dissection

이상길|박찬혁
대한소화기내시경학회 (The Korean Society Of Gastrointestinal Endoscopy)|2013.09|Clinical Endoscopy|제46권 제5호|pp. 456-462

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참고문헌

키워드

Prevention and controlHemorrhageHemostasisEndoscopic submucosal dissection
주제분류내과학

초록

Although techniques and instruments for endoscopic submucosal dissection (ESD) have improved, bleeding is still the most common complication. Minimizing the occurrence of bleeding is important because blood can interfere with subsequent procedures. Generally, ESD-related bleeding can be divided into intraprocedural and postprocedural bleedings. Postprocedural bleeding can be further classified into early post-ESD bleeding which occurs within 48 hours after ESD and late post-ESD bleeding which occurs later than 48 hours after ESD. A basic principle for avoiding intraprocedural bleeding is to watch for vessels and coagulate them before cutting. Several countertraction devices have been designed to minimize intraprocedural bleeding. Methods for reducing postprocedural bleeding include administration of proton-pump inhibitors or prophylactic coagulation after ESD. Medical adhesive spray such as n-butyl-2-cyanoacrylate is also an option for preventing postprocedural bleeding. Various endoscopic treatment modalities are used for both intraprocedural and postprocedural bleeding. However, hemoclipping is infrequently used during ESD because the clips interfere with subsequent resection. Bleeding that occurs as a result of ESD can usually be managed easily. Nonetheless, more effective ways to prevent bleeding, including reliable ESD techniques, must be developed.

Abstract

Although techniques and instruments for endoscopic submucosal dissection (ESD) have improved, bleeding is still the most common complication. Minimizing the occurrence of bleeding is important because blood can interfere with subsequent procedures. Generally, ESD-related bleeding can be divided into intraprocedural and postprocedural bleedings. Postprocedural bleeding can be further classified into early post-ESD bleeding which occurs within 48 hours after ESD and late post-ESD bleeding which occurs later than 48 hours after ESD. A basic principle for avoiding intraprocedural bleeding is to watch for vessels and coagulate them before cutting. Several countertraction devices have been designed to minimize intraprocedural bleeding. Methods for reducing postprocedural bleeding include administration of proton-pump inhibitors or prophylactic coagulation after ESD. Medical adhesive spray such as n-butyl-2-cyanoacrylate is also an option for preventing postprocedural bleeding. Various endoscopic treatment modalities are used for both intraprocedural and postprocedural bleeding. However, hemoclipping is infrequently used during ESD because the clips interfere with subsequent resection. Bleeding that occurs as a result of ESD can usually be managed easily. Nonetheless, more effective ways to prevent bleeding, including reliable ESD techniques, must be developed.

참고문헌 (54)

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관련 논문AI추천

Bleeding complication after endoscopic submucosal dissection of gastric neoplasmJi Yong Ahn소화기인터벤션의학회 · International Journal of Gastrointestinal Intervention2019 · 제8권 제3호A Randomized Controlled Trial to Evaluate the Effect of Fibrin Glue on Bleeding after Gastric Endoscopic Submucosal DissectionKim Jae J., Kim Tae-Jun, Kim Tae-Se, Lee Hyuk, Lee Jun Haeng, Min Byung-Hoon, Min Yang Won, Rhee Poong-Lyul거트앤리버 소화기연관학회협의회 · Gut and Liver2025 · 제19권 제5호Continuous Infusion versus Intermittent Dosing with Pantoprazole for Gastric Endoscopic Submucosal DissectionBong Eun Lee, Dong Hoon Baek, Dong Uk Kim, Geun Am Song, Gwang Ha Kim, Hye Kyung Jeon, Jong Hun Seo거트앤리버 소화기연관학회협의회 · Gut and Liver2019 · 제13권 제1호Is a Second-Look Endoscopy Necessary after Endoscopic Submucosal Dissection for Gastric Neoplasm?강기주, 김은란, 김재준, 김정하, 민병훈, 이종철, 이준행, 이풍렬거트앤리버 소화기연관학회협의회 · Gut and Liver2015 · 제9권 제1호Clinical Impact of Second-Look Endoscopy after Endoscopic Submucosal Dissection of Gastric Neoplasms문원, 김형훈, 박무인, 박선자거트앤리버 소화기연관학회협의회 · Gut and Liver2012 · 제6권 제3호Routine Mucosal Closure with a Detachable Snare and Clips after Endoscopic Submucosal Dissection for Gastric Epithelial Neoplasms: A Randomized Controlled Trial최황, 김병욱, 김형근, 이보인, 조영석, 지정선, 채현석, 최규용, Sun-Mee Hwang거트앤리버 소화기연관학회협의회 · Gut and Liver2011 · 제5권 제4호

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