Journal
DIGESTIVE ENDOSCOPY
Volume 27, Issue 3, Pages 279-284Publisher
WILEY
DOI: 10.1111/den.12410
Keywords
bleeding; endoscopic submucosal dissection (ESD); meta-analysis; second-look endoscopy; systematic review
Categories
Funding
- Astellas Pharm Inc.
- Astra-Zeneca K.K.
- Otsuka Pharmaceutical Co., Ltd
- Takeda Pharmaceutical Co., Ltd
- Zeria Pharmaceutical Co., Ltd
- Eisai Pharmaceutical Co., Ltd
- Tanabe Mitsubishi Pharmaceutical Co., Ltd
- JIMRO Co., Ltd
- Kyorin Pharmaceutical Co. Ltd
- Eisai Co.
- Top Corporation
- Kaigen Pharm Co., Ltd
- ASKA Pharmaceutical Co., Ltd
- FUJIFILM Corporation
- Boston Scientific Japan K.K.
- Century Medical Inc.
- Covidien Japan Inc.
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Routine second-look endoscopy after gastric endoscopic submucosal dissection (ESD) remains controversial. The aim of the present study was to systematically evaluate the efficacy of second-look endoscopy for gastric ESD. PubMed, the Cochrane library, and the Igaku-chuo-zasshi database were searched in order to identify randomized trials eligible for inclusion in the systematic review. Data were combined to calculate a pooled odds ratio (OR) for developing post-ESD bleeding. The database search yielded three randomized trials (854 patients). Compared with second-look endoscopy, the pooled OR for post-ESD bleeding without second-look endoscopy was 0.69 (95% confidence interval [CI]: 0.38-1.26, P = 0.228), without significant heterogeneity. There were no significant differences between second-look endoscopy and no second-look endoscopy with regard to large tumor size (>20 mm). This systematic review and meta-analysis showed that second-look endoscopy had no advantage for the prevention of post-ESD bleeding in patients without a high risk of bleeding.
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