Journals / Turkish Journal of Gastroenterology / 2017 / Cilt: 28 - Sayı: 5

Continued use of low-dose aspirin may increase risk of bleeding after gastrointestinal endoscopic submucosal dissection: A meta-analysis

Pages
329–336
DOI
—
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

All groups had similar ratios of en bloc resection.

📌 3 Key Takeaways

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Objective & Hypothesis:Background/Aims: Endoscopic submucosal dissection has been widely accepted.
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Key Findings & Data:The relationship between hemorrhage and continuous therapy with low-dose aspirin (LDA) remains controversial.Materials and Methods: A systematic search was conducted; studies were screened out- if data of no-anticoagulant/APT drugs use and interrupted and continued-LDA use were reported separately.
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Conclusion & Impact:All groups had similar ratios of en bloc resection.
🔬Design:Lab & Field Experiment
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Özet

Background/Aims: Endoscopic submucosal dissection has been widely accepted. At present, the number of antiplatelet (APT) users has been growing. Moreover, because of high risks of thromboembolism, some patients need to continuously receive APT agents. The relationship between hemorrhage and continuous therapy with low-dose aspirin (LDA) remains controversial.Materials and Methods: A systematic search was conducted; studies were screened out- if data of no-anticoagulant/APT drugs use and interrupted and continued-LDA use were reported separately. The Newcastle-scale was chosen to assess the quality of the included studies. Review Manager 5.2 was used for quality assessment statistical analysis, and the odd ratio (OR) and 95% confidence interval (CI) were calculated.Results: Pooled data suggested a significantly higher bleeding ratio in the LDA-continued group compared to both the LDA-interrupted group (OR=2.05, 95% CI=1.05-3.99) and no-anticoagulant/APT group (OR=2.89, 95% CI=1.86-4.47). However, the LDA-interrupted group did not differ significantly from the no-anticoagulant/APT group. The en bloc resection rates of the LDA-continued group versus the LDA-interrupted group, the LDAcontinued group versus no-anticoagulant/APT group, and the LDA-interrupted group versus the no-anticoagulant/APT group were similar (OR=0.82, 95% CI=0.21-3.24, p=0.78; OR=0.80, 95% CI=0.24-2.65, p=0.71; OR=1.41, 95% CI=0.38-5.24, p=0.60, respectively).Conclusion: There is an extremely high ratio of bleeding in the LDA-continued group compared to both the LDA-interrupted group and no-anticoagulant/APT group. All groups had similar ratios of en bloc resection.

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Cite This Article

WU, W., CHEN, J., DİNG, Q., YANG, D., YU, H., LİN, J. (2017). Continued use of low-dose aspirin may increase risk of bleeding after gastrointestinal endoscopic submucosal dissection: A meta-analysis. Turkish Journal of Gastroenterology, Cilt: 28 - Sayı: 5, 329–336. https://ajindex.com/articles/410195

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References (13)

  1. Chung IK, Lee JH, Lee SH, et al. Therapeutic outcomes in 1000 cases of endoscopic submucosal dissection for early gastric neoplasms: Korean ESD Study Group multicenter study. Gastrointest Endosc 2009; 69:1228-35
  2. Oka S, Tanaka S, Higashiyama M, et al. Clinical validity of the expanded criteria for endoscopic resection of undifferentiated-type early gastric cancer based on long-term outcomes. Surg Endosc 2014; 28: 639-47
  3. Nakamoto S, Sakai Y, Kasanuki J, et al. Indications for the use of endoscopic mucosal resection for early gastric cancer in Japan: a comparative study with endoscopic submucosal dissection. Endoscopy 2009; 41: 746-50
  4. Saito Y, Uraoka T, Yamaguchi Y, et al. A prospective, multicenter study of 1111 colorectal endoscopic submucosal dissections (with video). Gastrointest Endosc 2010; 72: 1217-25
  5. Tanaka S, Terasaki M, Kanao H, Oka S, Chayama K. Current status and future perspectives of endoscopic submucosal dissection for colorectal tumors. Dig Endosc 2012; 24: 73-9
  6. Tanaka S, Terasaki M, Hayashi N, Oka S, Chayama K. Warning for unprincipled colorectal endoscopic submucosal dissection: accurate diagnosis and reasonable treatment strategy. Dig Endosc 2013; 25: 107-16
  7. Saito I, Tsuji Y, Sakaguchi Y, et al. Complications related to gastric endoscopic submucosal dissection and their managements. Clin Endosc 2014; 47: 398-403
  8. Tsuji Y, Ohata K, Ito T, et al. Risk factors for bleeding after endoscopic submucosal dissection for gastric lesions. World J Gastroenterol 2010; 16: 2913-7
  9. Koh R, Hirasawa K, Yahara S, et al. Antithrombotic drugs are risk factors for delayed postoperative bleeding after endoscopic submucosal dissection for gastric neoplasms. Gastrointest Endosc 2013; 78: 476-83
  10. Lim JH, Kim SG, Kim JW, et al. Do antiplatelets increase the risk of bleeding after endoscopic submucosal dissection of gastric neoplasms? Gastrointest Endosc 2012; 75: 719-27
  11. Ninomiya Y, Oka S, Tanaka S, et al. Risk of bleeding after endoscopic submucosal dissection for colorectal tumors in patients with continued use of low-dose aspirin. J Gastroenterol 2015; 50: 1041-6
  12. Baigent C, Blackwell L, Conllis R, et al. Aspirin in the primary and secondary prevention of vascular disease: collaborative metaanalysis of individual participant data from randomised trials. Lancet 2009; 373: 1849-60
  13. Maulaz AB, Bezerra DC, Michel P, et al. Effect of discontinuing aspirin therapy on the risk of brain ischemic stroke. Arch Neurol 2005;