Endoscopic mucosa subdural peeling (ESD) is a minimally invasive treatment for patients with lymph nodes negative and with early stage stomach cancer (EGC).
, delayed bleeding after ESD is a frequent adverse event with an occurrence rate of between 3.1% and 6.5%.
in an aging society, the number of patients taking anti-thrombosis as a preventive treatment against cardiovascular disease is increasing.
Therefore, in the context of treatment with anticoagulants, including anticoagulants and plateboard drugs, the researchers observed that more and more patients were receiving ESD treatment, but that the increased risk of delayed bleeding had not been properly assessed.
the effects of direct oral anticoagulants (DOAC) on preventing thrombosis remain unclear.
, this study aims to explore the clinical effects of DOACs on delayed bleeding in patients with stomach cancer.
reviewed clinical data on 728 patients who received anticoagulants and ESD for gastric tumors in 25 medical facilities in Japan.
261 patients received DOAC treatment, including Dabiga (92), Devasaban (103), Apixaban (45) and Idosaban (21), while 467 patients received Huafarin treatment.
all patients were counted for bleeding after ESD.
results showed that 14 percent of patients taking DOAC had postoperative delayed bleeding, which was similar to the rate of patients receiving huafalin (18 percent).
patients treated with the Dabiga group had significantly lower rates of delayed bleeding than those treated with huafalin, and lower than those treated with other DOAC.
multi-factor analysis showed that age ≥65 years old, receiving a variety of anti-suppositive agents, removal of multiple lesions and lesions size ≥30 mm is an independent risk factor, and the suspension of anticoagulants is associated with reduced risk of bleeding.
multivariable analysis in patients receiving DOAC, and the treatment of the dabiga group was associated with a significant reduction in the risk of delayed bleeding.
doAC's effect on delayed bleeding varies from drug to drug, but D'Abiga group therapy minimizes the risk of delayed bleeding, the researchers concluded.
oral anticoagulants to dhabiga group during perivironment may be a reasonable option to reduce the risk of delayed bleeding after gastric ESD.