Multicenter Prospective Study on the Safety of Upper Gastrointestinal Endoscopic Procedures in Antithrombotic Drug Users

被引：10

作者：

Kono, Yoshiyasu ^{[1
]}

Matsubara, Minoru ^{[2
]}

Toyokawa, Tatsuya ^{[3
]}

Takenaka, Ryuta ^{[4
]}

Suzuki, Seiyu ^{[2
]}

Nasu, Junichirou ^{[5
]}

Yoshioka, Masao ^{[5
]}

Nakagawa, Masahiro ^{[6
]}

Mizuno, Motowo ^{[7
]}

Sakae, Hiroyuki ^{[1
]}

Abe, Makoto ^{[1
]}

Gotoda, Tatsuhiro ^{[1
]}

Miura, Ko ^{[1
]}

Kanzaki, Hiromitsu ^{[1
]}

Iwamuro, Masaya ^{[1
]}

Hori, Keisuke ^{[1
]}

Tsuzuki, Takao ^{[8
]}

Kita, Masahide ^{[9
]}

Kawano, Seiji ^{[1
]}

Kawahara, Yoshiro ^{[10
]}

Okada, Hiroyuki ^{[1
]}

机构：

[1] Okayama Univ, Dept Gastroenterol & Hepatol, Grad Sch Med Dent & Pharmaceut Sci, Kita Ku, 2-5-1 Shikata Cho, Okayama 7008558, Japan

[2] Sumitomo Bessi Hosp, Dept Internal Med, Niihama 7928543, Japan

[3] Fukuyama Med Ctr, Natl Hosp Org, Dept Gastroenterol, Fukuyama, Hiroshima 7208520, Japan

[4] Tsuyama Chuo Hosp, Dept Gastroenterol, Tsuyama 7080841, Japan

[5] Okayama Saiseikai Gen Hosp, Dept Internal Med, Okayama 7008551, Japan

[6] Hiroshima City Hosp, Dept Internal Med, Hiroshima 7308518, Japan

[7] Kurashiki Cent Hosp, Dept Internal Med, Kurashiki, Okayama 7108602, Japan

[8] Japanese Red Cross Soc Himeji Hosp, Dept Internal Med, Himeji, Hyogo 6708540, Japan

[9] Okayama City Hosp, Dept Internal Med, Okayama 7000833, Japan

[10] Okayama Univ Hosp, Dept Endoscopy, Okayama 7008558, Japan

来源：

DIGESTIVE DISEASES AND SCIENCES | 2017年 / 62卷 / 03期

关键词：

Antithrombotic drug; Endoscopy; Guidelines; Hemorrhage; Thromboembolism; EARLY GASTRIC-CANCER; SUBMUCOSAL DISSECTION; RISK-FACTORS; MUSCULARIS MUCOSAE; GI ENDOSCOPY; THERAPY; NEOPLASMS; INTERRUPTION; MANAGEMENT; RESECTION;

D O I：

10.1007/s10620-016-4437-2

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

The Japan Gastroenterological Endoscopy Society updated its guidelines for gastroenterological endoscopy in patients undergoing antithrombotic treatment in July 2012. However, the safety of endoscopic procedures in antithrombotic drug users has not been fully investigated. To evaluate the safety of upper gastrointestinal endoscopic procedures in antithrombotic drug users. From September 2013 to September 2015, patients who were taking antithrombotic drugs and who underwent upper gastrointestinal endoscopic procedures were prospectively enrolled at five hospitals. Incidences of bleeding and thrombosis during endoscopic procedures were evaluated. A total of 270 patients [221 for endoscopic mucosal biopsy and 49 for endoscopic mucosal resection (EMR)/endoscopic submucosal dissection (ESD) were enrolled. The bleeding rate was 0.9% for endoscopic mucosal biopsy and 22% for EMR/ESD, respectively. The bleeding rate after endoscopic mucosal biopsy was not significantly high, even if antithrombotic drugs were continued (0 vs. 1%, P > 0.99), while it was significantly higher among multiple antithrombotic drug users than single drug users (5.9 vs. 0%, P < 0.05). The bleeding rate after EMR/ESD was also higher among multiple antithrombotic drug users than single drug users, but was not significantly different (33 vs. 14%, P = 0.17). Moreover, there were no differences in bleeding rates according to the cessation or continuance of antithrombotic drugs (20 vs. 25%, P = 0.74). There were no thromboembolisms in all cases. Upper gastrointestinal endoscopic procedures performed under the new guidelines appear acceptable. However, endoscopic procedures among multiple antithrombotic drug users show a greater potential for bleeding.

引用

页码：730 / 738

页数：9

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