| Theme | Management of antithrombotic agents for colorectal endoscopic procedures -- Validity of new guideline by Japan Gastroenterological Endoscopy Society | |
|---|---|---|
| Title | Clinical outcomes of ESD in patients taking antiplatelet and anticoagulation agents -- PGA felt sealing method for prevention of bleeding related to ESD | |
| Publish Date | 2014/09 | |
| Author | Naoyuki Yamaguchi | Department of Endoscopy, Nagasaki University Hospital |
| Author | Hiroko Fukuda | Gastroenterology and Hepatology, Nagasaki University Hospital |
| Author | Hajime Isomoto | Department of Endoscopy, Nagasaki University Hospital |
| Author | Hitomi Minami | Gastroenterology and Hepatology, Nagasaki University Hospital |
| Author | Kayoko Matsushima | Gastroenterology and Hepatology, Nagasaki University Hospital |
| Author | Yuko Akazawa | Gastroenterology and Hepatology, Nagasaki University Hospital |
| Author | Ken Ohnita | Gastroenterology and Hepatology, Nagasaki University Hospital |
| Author | Fuminao Takeshima | Gastroenterology and Hepatology, Nagasaki University Hospital |
| Author | Saburo Shikuwa | Gastroenterology and Hepatology, Nagasaki University Hospital |
| Author | Kazuhiko Nakao | Gastroenterology and Hepatology, Nagasaki University Hospital |
| [ Summary ] | With the advent of a super-aging society, the number of patients taking antithrombotic agents has increased. Gastrointestinal endoscopy practice guidelines for antithrombotic agent recipients were established in 2012. It has become increasingly important to appropriately determine whether antithrombotic agents should be stopped or adjusted in relation to endoscopic therapy. However, it is expected that when performing ESD for patients receiving antithrombotic agents, the frequency of delayed bleeding may increase. There is a possibility that the endoscopic PGA felt and fibrin glue sealing method that Takimoto et al used to prevent delayed perforations after duodenal ESDs may become a new method of preventing delayed bleeding. We examined the safety of ESD and the efficacy of the endoscopic tissue sealing method with PGA felt and fibrin glue for prevention of post-ESD bleeding in patients taking antiplatelet agents or anticoagulation agents and alternative therapy with heparin. The delayed bleeding rates were 0 % in the sealing group, 17.6 % in the non-sealing group, and 6.9 % in the non-antithrombotic therapy group. Delayed bleeding rates in the sealing group tended to be lower than in the non-sealing group or the non-antithrombotic therapy group. The PGA felt and fibrin glue sealing method may become a new post-ESD bleeding prevention method in patients taking antithrombotic agents. |
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