Second-look endoscopy after endoscopic submucosal dissection for gastric neoplasms

Toshihiro Nishizawa, Hidekazu Suzuki, Satoshi Kinoshita, Osamu Goto, Takanori Kanai, Naohisa Yahagi

Research output: Contribution to journalReview articlepeer-review

21 Citations (Scopus)


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 Cochrane library, and the Igaku-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.

Original languageEnglish
Pages (from-to)279-284
Number of pages6
JournalDigestive Endoscopy
Issue number3
Publication statusPublished - 2015 Mar 1


  • bleeding
  • endoscopic submucosal dissection (ESD)
  • meta-analysis
  • second-look endoscopy
  • systematic review

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology


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