Continuous use of antithrombotic medications during peri‐endoscopic submucosal dissection period for colorectal lesions: A propensity score matched study
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- Keisuke Kawasaki
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences Kyushu University Fukuoka Japan
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- Takehiro Torisu
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences Kyushu University Fukuoka Japan
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- Motohiro Esaki
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences Kyushu University Fukuoka Japan
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- Makoto Eizuka
- Division of Gastroenterology, Department of Internal Medicine Iwate Medical University Yahaba Japan
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- Shinichiro Kawatoko
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences Kyushu University Fukuoka Japan
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- Tomo Kumei
- Division of Gastroenterology, Department of Internal Medicine Iwate Medical University Yahaba Japan
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- Minami Hirai
- Division of Gastroenterology, Department of Internal Medicine Iwate Medical University Yahaba Japan
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- Masahiro Kondo
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences Kyushu University Fukuoka Japan
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- Shin Fujioka
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences Kyushu University Fukuoka Japan
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- Yuta Fuyuno
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences Kyushu University Fukuoka Japan
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- Yuichi Matsuno
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences Kyushu University Fukuoka Japan
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- Junji Umeno
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences Kyushu University Fukuoka Japan
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- Tomohiko Moriyama
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences Kyushu University Fukuoka Japan
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- Takanari Kitazono
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences Kyushu University Fukuoka Japan
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- Tamotsu Sugai
- Department of Diagnostic Pathology Iwate Medical University Yahaba Japan
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- Takayuki Matsumoto
- Division of Gastroenterology, Department of Internal Medicine Iwate Medical University Yahaba Japan
説明
<jats:title>Abstract</jats:title><jats:sec><jats:title>Background and Aim</jats:title><jats:p>The aim of this study was to elucidate the continuous use of antithrombotic medications during the peri‐colorectal endoscopic submucosal dissection (ESD) period.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>This study included 468 patients with colorectal epithelial neoplasms treated by ESD, consisting of 82 under antithrombotic medications and 386 patients without the medications. Among patients taking antithrombotic medications, antithrombotic agents were continued during the peri‐ESD period. Clinical characteristics and adverse events were compared after propensity score matching.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Before and after propensity score matching, post‐colorectal ESD bleeding rate was higher in patients continuing antithrombotic medications (19.5% and 21.6%, respectively) than in those not taking antithrombotic medications (2.9% and 5.4%, respectively). In the Cox regression analysis, continuation of antithrombotic medications was associated with post‐ESD bleeding risk (hazard ratio, 3.73; 95% confidence interval, 1.2–11.6; <jats:italic>P</jats:italic> < 0.05) compared with patients without antithrombotic therapy. All patients who experienced post‐ESD bleeding were successfully treated by endoscopic hemostasis procedure or conservative therapy.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Continuation of antithrombotic medications during the peri‐colorectal ESD period increases the risk of bleeding. However, the continuation may be acceptable under careful monitoring for post‐ESD bleeding.</jats:p></jats:sec>
収録刊行物
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- Journal of Gastroenterology and Hepatology
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Journal of Gastroenterology and Hepatology 38 (6), 955-961, 2023-02-26
Wiley