AIM To investigated the relationship between postoperative bleeding following gastric endoscopic submucosal dissection (ESD) and individual antithrombotic agents. METHODS A total of 2488 gastric neoplasms in 2148 consecutive patients treated between May 2001 and June 2016 were studied. The antithrombotic agents were categorized into antiplatelet agents, anticoagulants, and other antithrombotic agents, and we included combination therapies [ e.g ., dual antiplatelet therapy (DAPT)]. The risk factors associated with post-ESD bleeding, namely, antithrombotic agents overall, individual antithrombotic agents, withdrawal or continuation of antithrombotic agents, and bleeding onset period (during the first six days or thereafter), were analyzed using univariate and multivariate analyses. RESULTS The en bloc resection and complete curative resection rates were 99.2% and 91.9%, respectively. Postoperative bleeding occurred in 5.1% cases. Bleeding occurred in 10.3% of the patients administered antithrombotic agents. Being male ( P = 0.007), specimen size ( P P P = 0.002) and DAPT/multidrug combinations ( P P P = 0.015), and bleeding after POD 7 was significantly higher in DAPT/multidrug combinations ( P = 0.007). No thromboembolic events were reported. CONCLUSION We must closely monitor patients administered HBT and DAPT/multidrug combinations after gastric ESD, particularly those administered multidrug combinations after discharge.
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机译：目的探讨胃内镜下黏膜下剥离术（ESD）术后出血与个别抗栓剂之间的关系。方法对2001年5月至2016年6月期间接受治疗的2148例连续胃癌患者中的2488例胃肿瘤进行了研究。抗血栓药分为抗血小板药，抗凝药和其他抗血栓药，我们纳入了联合疗法[例如双重抗血小板疗法（DAPT）]。使用单因素和多因素分析来分析与ESD术后出血相关的危险因素，即总体抗血栓药，单独的抗血栓药，停药或继续使用抗血栓药以及出血发作时间（在开始的六天或之后）。结果整体切除和完全根治性切除率分别为99.2％和91.9％。术后出血发生率为5.1％。服用抗血栓药的患者中有10.3％出现出血。男性（P = 0.007），标本大小（P P P = 0.002）和DAPT /多药组合（P P P = 0.015），POD 7后的出血在DAPT /多药组合中明显更高（P = 0.007）。没有血栓栓塞事件的报道。结论我们必须密切监测胃ESD后使用HBT和DAPT /多种药物联合治疗的患者，尤其是出院后联合使用多种药物治疗的患者。
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