Your browser doesn't support javascript.
loading
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.
Subject(s)

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

Similar

MEDLINE

...
LILACS

LIS

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