Usefulness of the Forrest Classification to Predict Artificial Ulcer Rebleeding during Second-Look Endoscopy after Endoscopic Submucosal Dissection
Clinical Endoscopy
;
: 273-281, 2016.
Article
in English
| WPRIM
| ID: wpr-175024
ABSTRACT
BACKGROUND/AIMS:
Delayed post-endoscopic submucosal dissection (ESD) bleeding (DPEB) is difficult to predict and there is controversy regarding the usefulness of prophylactic hemostasis during second-look endoscopy. This study evaluated the risk factors related to DPEB, the relationship between clinical outcomes and the Forrest classification, and the results of prophylactic hemostasis during second-look endoscopy.METHODS:
Second-look endoscopy was performed on the day after ESD to check for recent hemorrhage or potential bleeding and the presence of artificial ulcers in all patients.RESULTS:
DPEB occurred in 42 of 581 patients (7.2%). Multivariate analysis determined that a specimen size ≥40 mm (odds ratio [OR], 3.03; p=0.003), and a high-risk Forrest classification (Forrest Ib+IIa+IIb; OR, 6.88; p<0.001) were risk factors for DPEB. DPEB was significantly more likely in patients classified with Forrest Ib (OR, 24.35; p<0.001), IIa (OR, 12.91; p<0.001), or IIb (OR, 8.31; p<0.001) ulcers compared with Forrest III ulcers. There was no statistically significant difference between the prophylactic hemostasis and non-hemostasis groups (Forrest Ib, p=0.938; IIa, p=0.438; IIb, p=0.397; IIc, p=0.773) during second-look endoscopy.CONCLUSIONS:
The Forrest classification of artificial gastric ulcers during second-look endoscopy seems to be a useful tool for predicting delayed bleeding. However, routine prophylactic hemostasis during second-look endoscopy seemed to not be useful for preventing DPEB.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Stomach Neoplasms
/
Stomach Ulcer
/
Ulcer
/
Multivariate Analysis
/
Risk Factors
/
Classification
/
Hemostasis, Endoscopic
/
Endoscopy
/
Hemorrhage
/
Hemostasis
Type of study:
Etiology study
/
Prognostic study
/
Risk factors
Limits:
Humans
Language:
English
Journal:
Clinical Endoscopy
Year:
2016
Type:
Article
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