{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T17:32:57Z","timestamp":1790875977274,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2021,5,26]],"date-time":"2021-05-26T00:00:00Z","timestamp":1621987200000},"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":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aim<\/jats:title>\n                    <jats:p>This study aimed to reveal the timing of bleeding and thromboembolism associated with endoscopic submucosal dissection (ESD) for early gastric cancer (EGC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed \u00a010,320 patients who underwent ESD for EGC during November 2013\u2013October 2016. We evaluated overall bleeding rates and their inter\u2010group differences. Factors associated with early\/late (cut\u2010off 5\u00a0days) bleeding and thromboembolism frequency and its association with the intake of antithrombotic agents were investigated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, the post\u2010ESD bleeding rate was 4.7% (489\/10\u00a0320); the median time to post\u2010ESD bleeding was 4\u00a0days. The post\u2010ESD bleeding rates were 3.2%, 8.7%, 15.5%, and 29.9% in those not taking antithrombotic agents, those taking antiplatelet agents, those taking anticoagulants (ACs), and those taking antiplatelet agents and ACs. Warfarin (odds ratio [OR], 9.16), direct oral ACs (OR, 4.16), chronic kidney disease with hemodialysis (OR, 2.93), thienopyridine (OR, 2.25), aspirin (OR, 1.66), tumor size &gt;30\u00a0mm (OR, 1.86), multiple tumors' resection (OR, 1.54), and tumor in the lower third of the stomach (OR, 1.40) were independent risk factors for early bleeding. The independent risk factors for late bleeding were direct oral ACs (OR, 7.42), chronic kidney disease with hemodialysis (OR, 4.99), warfarin (OR, 3.90), thienopyridine (OR, 3.09), liver cirrhosis (OR, 2.43), cilostazol (OR, 1.93), aspirin (OR, 1.92), ischemic heart disease (OR, 1.77), and male sex (OR, 1.65). There were three (0.03%) thromboembolic events (cerebral infarction\u00a0=\u00a02, transient ischemic attack\u00a0=\u00a01).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We revealed the timing of bleeding and risk factors for early\/late bleeding and showed the thromboembolism frequency associated with ESD for EGC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgh.15536","type":"journal-article","created":{"date-parts":[[2021,5,8]],"date-time":"2021-05-08T15:28:01Z","timestamp":1620487681000},"page":"2769-2777","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Timing of bleeding and thromboembolism associated with endoscopic submucosal dissection for gastric cancer in Japan"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7597-1790","authenticated-orcid":false,"given":"Sho","family":"Shiroma","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Cancer Institute Hospital  Tokyo Japan"},{"name":"Department of Gastroenterology Okinawa Kyodo Hospital  Naha Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waku","family":"Hatta","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Tohoku University Graduate School of Medicine  Sendai Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yosuke","family":"Tsuji","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Graduate School of Medicine University of Tokyo  Tokyo 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Kobe University Graduate School of Medicine  Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuya","family":"Sumiyoshi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Tonan Hospital  Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikitaka","family":"Iguchi","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine Wakayama Medical University  Wakayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideomi","family":"Tomida","sequence":"additional","affiliation":[{"name":"Gastroenterology Center Ehime Prefectural Central Hospital  Matsuyama Japan"},{"name":"Department of Gastroenterology and Metabology, Graduate School of Medicine Ehime University  Matsuyama 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Digestive Endoscopy Shiga University of Medical Science Hospital  Kusatsu Japan"},{"name":"Department of Gastroenterological Endoscopy Tokyo Medical University Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinjiro","family":"Yamaguchi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Kansai Rosai Hospital  Amagasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoki","family":"Michida","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Saitama Medical Center  Kawagoe Japan"},{"name":"Gastrointestinal Oncology Osaka International Cancer Institute  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoyuki","family":"Yada","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Kohnodai Hospital, National Center for Global Health and Medicine  Tokyo 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