{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T16:58:20Z","timestamp":1785344300915,"version":"3.55.0"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,1,26]],"date-time":"2018-01-26T00:00:00Z","timestamp":1516924800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>The safety of gastric endoscopic submucosal dissection (ESD) in the antithrombotic drug users remains controversial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients who underwent gastric ESD at Okayama University Hospital between March 2006 and February 2016 were enrolled. This study investigated the risk of post\u2010ESD bleeding according to the management of the antithrombotic drugs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One thousand twenty lesions (872 patients) were enrolled. In a multivariate analysis, heparin replacement (odds ratio [OR] 5.0, 95% confidence interval [CI] 1.8\u201314), multiple antithrombotic drug use (OR 2.9, 95% CI 1.1\u20136.9), a resected specimen of \u2265\u00a033\u00a0mm in diameter (OR 2.7, 95% CI 1.5\u20135.4), <jats:italic>Helicobacter pylori<\/jats:italic> negativity (OR 2.2, 95% CI 1.3\u20133.7), and tumors located in the lower third of the stomach (OR 1.7, 95% CI 1.0\u20132.9) were significant risk factors for post\u2010ESD bleeding, while the continuation of aspirin or cilostazol was not (OR 2.6, 95% CI 0.72\u20137.8). The bleeding rate of the continuation group was comparable with that of the all cessation group among single antithrombotic drug users (4.5% <jats:italic>vs<\/jats:italic> 4.4%, <jats:italic>P<\/jats:italic>\u00a0=\u00a01.0); however, the rate of the continuation group was significantly higher than that of the all cessation group among multiple antithrombotic drug users (67% <jats:italic>vs<\/jats:italic> 15%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.020).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The risk of post\u2010ESD bleeding differed according to the management of the antithrombotic drugs. The gastric ESD under the cessation or continuation of aspirin or cilostazol monotherapy was acceptable. However, multiple antithrombotic drug use or heparin replacement was associated with a higher risk of post\u2010ESD bleeding.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.13872","type":"journal-article","created":{"date-parts":[[2017,7,11]],"date-time":"2017-07-11T11:24:31Z","timestamp":1499772271000},"page":"453-460","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Postoperative bleeding risk after gastric endoscopic submucosal dissection during antithrombotic drug therapy"],"prefix":"10.1111","volume":"33","author":[{"given":"Yoshiyasu","family":"Kono","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuka","family":"Obayashi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Baba","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Sakae","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuhiro","family":"Gotoda","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ko","family":"Miura","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiromitsu","family":"Kanzaki","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaya","family":"Iwamuro","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seiji","family":"Kawano","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiro","family":"Kawahara","sequence":"additional","affiliation":[{"name":"Department of Endoscopy Okayama University Hospital  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takehiro","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Pathology Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Okada","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,1,26]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10120-006-0389-0"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2012.06.014"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-011-1627-z"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2013.03.008"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2016.06.033"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.12183"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2015.09.035"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2015-311110"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10120-013-0305-3"},{"key":"e_1_2_5_11_1","article-title":"Postoperative bleeding after gastric endoscopic submucosal dissection in patients receiving antithrombotic therapy","author":"Furuhata T","year":"2016","journal-title":"Gastric. 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