Harada H, Suehiro S, Murakami D, Nakahara R, Nagasaka T, Ujihara T, Sagami R, Katsuyama Y, Hayasaka K, Amano Y. Feasibility of gastric endoscopic submucosal dissection with continuous low-dose aspirin for patients receiving dual antiplatelet therapy. World J Gastroenterol 2019; 25(4): 457-468 [PMID: 30700942 DOI: 10.3748/wjg.v25.i4.457]
Corresponding Author of This Article
Hideaki Harada, MD, Chief Doctor, Department of Gastroenterology, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba 270-2232, Japan. nerimaendo@hotmail.co.jp
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Hideaki Harada, Satoshi Suehiro, Daisuke Murakami, Ryotaro Nakahara, Takuya Nagasaka, Tetsuro Ujihara, Ryota Sagami, Yasushi Katsuyama, Kenji Hayasaka, Department of Gastroenterology, New Tokyo Hospital, Matsudo, Chiba 270-2232, Japan
Yuji Amano, Department of Endoscopy, New Tokyo Hospital, Matsudo, Chiba 270-2232, Japan
Author contributions: Harada H wrote the manuscript and analyzed the data. Amano Y gave the final approval of the manuscript. All the other authors collected the data, check the manuscript, and suggested improvement.
Institutional review board statement: This study was reviewed and approved by the New Tokyo Hospital Institutional Review Committee.
Informed consent statement: The procedure participant provided informed written consent.
Conflict-of-interest statement: There are no conflicts of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Hideaki Harada, MD, Chief Doctor, Department of Gastroenterology, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba 270-2232, Japan. nerimaendo@hotmail.co.jp
Telephone: +81-47-7118700 Fax: +81-47-3928718
Received: November 29, 2018 Peer-review started: November 29, 2018 First decision: December 12, 2018 Revised: December 19, 2018 Accepted: January 9, 2019 Article in press: January 9, 2019 Published online: January 28, 2019
ARTICLE HIGHLIGHTS
Research background
The postoperative bleeding after gastric endoscopic submucosal dissection (ESD) with continuous low dose aspirin (LDA) in patients with dual antiplatelet therapy (DAPT) is unclear.
Research motivation
Previous studies have had several limitations, such as small sample size and use of other types of thienopyridines, such as ticlopidine. We investigated the effect of only clopidogrel as thienopyridine.
Research objectives
Evaluate the postoperative bleeding for the effect of continuous LDA in patients with DAPT.
Research methods
A total of 597 patients with gastric neoplasms treated with ESD between January 2010 and June 2017 were enrolled. Among them, we analyzed 59 patients receiving DAPT. The main outcome was the postoperative bleeding after ESD.
Research results
The bleeding rate with continuous LDA in patients receiving DAPT (23.1%) was higher than that with discontinuous LDA in patients receiving DAPT (5.0%).
Research conclusions
The bleeding rate with continuous LDA in patients receiving DAPT was not statistically different from that with discontinuous LDA in patients receiving DAPT.
Research perspectives
The continuous LDA administration may be acceptable for gastric ESD in patients receiving DAPT, although patients should be carefully monitored for possible postoperative bleeding.
