| 위 종양의 내시경적 점막절제술 후 출혈의 위험인자 |
| 이영두·서향은·전성우·이명권·이동석·권기태·조창민·탁원영·권영오·김성국·최용환 |
| 경북대학교병원 내과 |
| Risk Factors Related to Bleeding after Endoscopic Mucosal Resection of Gastric Tumors |
| Young Doo Lee, M.D., Hyang Eun Seo, M.D., Seong Woo Jeon, M.D., Myung Kwon Lee, M.D., Dong Seok Lee, M.D., Ki Tae Kwon, M.D., Chang Min Cho, M.D., Won Young Tak, M.D., Young Oh Kweon, M.D., Sung Kook Kim, M.D. and Yong Hwan Choi, M.D. |
| Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea |
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| Abstract |
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Background/Aims:
Endoscopic mucosal resection (EMR) has been widely used for treatment of gastric mucosal tumors because of its relative safety and minimal invasiveness. However, the bleeding after EMR has been regarded as a major complication. Herein, we assessed the bleeding rates and risk factors related to bleeding after EMR.
Methods:
We retrospectively analyzed the medical records of two hundred and fortynine patients with 283 lesions who underwent EMR for flat adenoma (78.8%), hyperplastic polyp (4.9%), and early gastric cancer (16.3%) from January 1999 to August 2003. Bleeding during EMR was defined as an immediate bleeding while bleeding on follow-up day endoscopy after EMR was considered as an delayed bleeding We evaluated risk factors related to bleeding using univariate and multivariate analysis.
Results:
Bleeding after EMR occurred in 99 patients (35%). Immediate bleeding occurred in 31.8% and was more frequent in the case of beginners, upper part of the stomach or EMR prcedures using needle knife. Delayed bleeding occurred in 7.1% and was more frequent in the case of flat or depressed lesions, or occurrence after the incidence of immediate bleeding. Risk factors related to EMR bleeding were experience of operator (beginner vs. expert, p= 0.001), anatomical location (upper vs. lower, p=0.018), and methods of procedure (needle-knife vs. snare or band, p=0.001).
Conclusions:
We concluded that experience of operator, anatomical location, and method of procedure were the risk factors related to bleeding after EMR. (Korean J Gastrointest Endosc 2005;30:297304) |
| Key Words:
Bleeding, Endoscopic mucosal resection, Risk factor |
| 주요어:
내시경적 점막절제술, 위험인자, 출혈 |
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