Antithrombotic drug use effect in the treatment of early gastric cancer by endoscopic submucosal dissection

Abstract

This study was designed to investigate the efficacy and safety of endoscopic submucosal dissection (ESD) for treatment of early gastric cancer. In this study, we evaluated the effects of antithrombotic drugs on bleeding risk in patients with ESD. Meta analysis showed that the use of antithrombotic drugs before ESD can reduce the risk of postoperative bleeding, but the early recovery of the use of antithrombotic drugs, or combined with a variety of antithrombotic drugs will increase the risk of bleeding. Twenty-four lesions in 524 patients were treated using ESD, and treatment status and efficacy were observed. Patients received intravenous antibiotics 30 minutes before ESD to prevent infection. If infection occurred after ESD, according to susceptibility test results, patients were given sensitive antibiotics. The one-time en bloc resection rate of all 524 lesions was 100%, and the histologic curative resection rate was 100%. The average time of surgery was 48 min. The rate of mild acute bleeding was 4.2% (22/524), the incidence of postoperative abdominal pain was 54.2% (284/524), and no heavy acute bleeding, perforation, or delayed postoperative bleeding occurred. Endoscopic re-examination at 2 months revealed an ulcer healing rate of 100%. A 12-month follow-up revealed no local residue, relapse, or new lesions. ESD can increase the one-time en bloc resection rate and histologic curative resection rate, and is a safe and effective method for treatment of early gastric cancer.