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Risk factors for bleeding after endoscopic mucosal resection

World Journal of Gastroenterology 2005年第46期11卷 7335-7339页

作者： Masatsugu Shiba Kazuhide Higuchi kaori Kadouchi Ai Montani Kazuki Yamamori Hirotoshi Okazaki Makiko Taguchi Tomoko Wada Atsushi Itani Toshio Watanabe Kazunari Tominaga Yoshihiro Fujiwara Tomoshige hayashi Kei Tsumura Tetsuo Arakawa Department of GastroenterologyOsaka City University Medical School OsakaJapan Department of GastroenterologyOsaka City University Medical School OsakaJapan Department of Preventive Medicine and Environmental HealthOsaka City University Medical SchoolOsakaJapan Department of GastroenterologyOsaka City University Medical School OsakaJapan Department of CardiologyOsaka City University Medical SchoolOsakaJapan

AIM: To clarify the risk factors for bleeding after endoscopic mucosal resection (EMR).METHODS: A total of 297 consecutive patients who underwent EMR were enrolled. Some of the patients had multiple lesions. Bleeding requiring endoscopic treatment was defined as bleeding after EMR. Odds ratios (OR) with 95% confidence intervals (CI), calculated by logistic regression with multivariate adjustments for covariates,were the measures of association.RESULTS: Of the 297 patients, 57 (19.2%) patients with bleeding after EMR were confirmed. With multivariate adjustment, the cutting method of ENR, diameter, and endoscopic pattern of the tumor were associated with the risk of bleeding after ENR. The multivariate-adjusted OR for bleeding after EMR using endoscopic aspiration mucosectomy was 3.07 (95%CI, 1.59-5.92) compared with strip biopsy. The multiple-adjusted OR for bleeding after EMR for the highest quartile (16-50 mm) of tumor diameter was 5.63 (95%CI, 1.84-17.23) compared with that for the lowest (4-7 mm). The multiple-adjusted OR for bleeding after EM R for depressed type of tumor was 4.21 (95%CI, 1.75-10.10) compared with elevated type.CONCLUSION: It is important to take tumor characteristics (tumor size and endoscopic pattern) and cutting method of EMR into consideration in predicting bleeding after ENR.

关键词：内窥镜治疗损伤致病因子

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