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首页> 外文期刊>Endoscopy International Open >Effect of anticoagulants on the risk of delayed bleeding after colorectal endoscopic submucosal dissection
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Effect of anticoagulants on the risk of delayed bleeding after colorectal endoscopic submucosal dissection

机译：抗凝血剂对结肠直肠内镜粘膜下粘膜粘膜后延迟出血风险的影响

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Background and study aims?In patients receiving antithrombotic therapy, the risks of delayed bleeding after endoscopic procedures for gastrointestinal neoplasms become a major problem. Few reports have shown the effects of delayed bleeding in patients taking anticoagulants after colorectal endoscopic submucosal dissection (ESD). This study aimed to evaluate the delayed bleeding events after colorectal ESD in patients receiving anticoagulant therapy. Patients and methods?We retrospectively analyzed 87 patients taking anticoagulants who underwent colorectal ESD from April 2012 to December 2017?at 13 Japanese institutions participating in the Osaka Gut Forum. Among these patients, warfarin users were managed with heparin bridge therapy (HBT), continued use of warfarin, a temporary switch to direct oral anticoagulation (DOAC), or withdrawal of warfarin, and DOAC users were managed with DOAC discontinuation with or without HBT. We investigated the occurrence rate of delayed bleeding and compared the rates between warfarin and DOAC users. Results?The delayed bleeding rate was 17.2?% among all patients. The delayed bleeding rate was higher in DOAC users than in warfarin users (23.3?% vs. 11.4?%, P?=?0.14), although no statistically significant difference was observed. In DOAC users, the delayed bleeding rates for dabigatran, rivaroxaban, apixaban, and edoxaban users appeared similar (30?%, 18.2?%, 22.2?%, and 25?%, respectively). The onset of delayed bleeding in both warfarin and DOAC users was late, averaging 6.9 and 9.4 days, respectively. Conclusions?Among patients taking anticoagulants, the risk of delayed bleeding after colorectal ESD was relatively high and the onset of delayed bleeding was late.
机译：背景和研究旨在？在接受抗血栓形成患者的患者中，胃肠肿瘤内窥镜肿瘤内窥镜程序后延迟出血的风险成为一个主要问题。很少有报道表明，在结肠直肠内镜粘膜下解剖（ESD）后服用抗凝血剂患者延迟出血的影响。本研究旨在评估抗凝治疗患者结肠直肠ESD后的延迟出血事件。患者和方法？我们回顾性地分析了87名服用抗凝血剂的抗凝血剂，抗凝血剂从2012年4月到2017年12月进行结直肠ESD？在参加大阪勇气论坛的13个日本机构。在这些患者中，Warfarin用户用肝素桥治疗（HBT）进行管理，继续使用Warfarin，临时切换到直接口服抗凝（Doac），或者撤离华法林，Doac用户与Doac停止，有或没有HBT。我们调查了延迟出血的发生率，并比较了华法林和Doac用户的税率。结果？所有患者中延迟出血率为17.2？％。 Doac用户的延迟出血率高于华法林用户（23.3〜11.4〜4.4℃，p？= 0.14），但观察到没有统计学上的差异。在Doac用户中，Dabigatran，Rivaroxaban，Apixaban和Edoxaban用户的延迟出血率类似于相似（30？％，18.2〜2％，22.2μl％和25μl％）。 Warfarin和Doac用户延迟出血的发作分别延迟，平均为6.9和9.4天。结论？服用抗凝剂的患者中，结肠直肠ESD后延迟出血的风险相对较高，延迟出血的发作已晚。

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