In:
Journal of Gastroenterology and Hepatology, Wiley, Vol. 28, No. 9 ( 2013-09), p. 1489-1495
Kurzfassung:
Gastric cancer bleeding is not rare complication in patients with advanced gastric cancer ( AGC ). The aim of this study was to evaluate the efficacy and clinical outcomes of endoscopic therapy ( ET ) for upper gastrointestinal bleeding ( UGIB ) from unresectable AGC . Methods Data from 113 patients with UGIB from unresectable AGC who underwent ET at the N ational C ancer C enter, K orea were analyzed retrospectively. Success rates of endoscopic hemostasis, rebleeding rates, mortality at 30 days, and overall survival ( OS ) rate after initial hemostasis were investigated. Results The initial hemostasis rate was 92.9% (105/113). Electrocoagulation was the most common method used (92.0%, 104/113), and combination ET was required in 34 patients (30.1%). Rebleeding occurred in 43 patients (41.0%); 3‐day and 30‐day rebleeding rates were 18.1% and 29.5%, respectively. Multivariate logistic regression analysis showed that transfusion of packed red blood cells ( 〉 5 units) was associated with early rebleeding (≤ 3 days after initial hemostasis) (odd ratio, 4.75; 95% confidential interval, 1.45–15.57; P = 0.010). ET was attempted in 18 patients with rebleeding; hemostasis was achieved in 88.9%. The 30‐day mortality rate after initial bleeding event was 15.9%. Median OS after initial hemostasis was 3.2 months. OS was lower for patients with early rebleeding than for those with late rebleeding ( 〉 3 days after initial hemostasis) or without rebleeding (1.0, 3.1, and 4.3 months, respectively; P = 0.004). Conclusions ET , primarily endoscopic electrocoagulation, achieved a high initial hemostasis rate for UGIB in patients with unresectable AGC . However, rebleeding frequently occurred, and early rebleeding was associated with poor survival.
Materialart:
Online-Ressource
ISSN:
0815-9319
,
1440-1746
DOI:
10.1111/jgh.2013.28.issue-9
Sprache:
Englisch
Verlag:
Wiley
Publikationsdatum:
2013
ZDB Id:
2006782-3
