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Second‐look endoscopy after endoscopic submucosal dissection for gastric neoplasms
Author(s) -
Nishizawa Toshihiro,
Suzuki Hidekazu,
Kinoshita Satoshi,
Goto Osamu,
Kanai Takanori,
Yahagi Naohisa
Publication year - 2015
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/den.12410
Subject(s) - medicine , endoscopy , endoscopic submucosal dissection , odds ratio , randomized controlled trial , confidence interval , therapeutic endoscopy , meta analysis , gastroenterology , general surgery , surgery , radiology
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 C ochrane library, and the I gaku‐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.