Delayed bleeding rate according to the Forrest classification in second-look endoscopy after endoscopic resection for gastric neoplasm

Background: We evaluated the delayed bleeding rate according to the Forrest classification when omitting the routine coagulation of non-bleeding visible vessels in second-look endoscopy.Methods: Between July 2011 and February 2012, 904 lesions in 829 consecutive patients who underwent second-look endoscopy after endoscopic resection were prospectively investigated. Endoscopic finding was described according to Forrest classification. We have evaluated the rate of late delayed bleeding in non-bleeding visible vessels (Forrest classification IIa) that were not treated preventively during second-look endoscopy and the risk factors for late delayed bleeding.Results: Among the 904 gastric tumors analyzed, early and late delayed bleeding after endoscopic resection occurred in 83 (9.2%) and 32 (3.5%) lesions, respectively. On second-look endoscopy, Forrest II and III lesions (not treated in second-look endoscopy) were found in 821 cases (IIa, 76 lesions [8.4%]; IIb, 137 lesions [15.2%]; IIc, 603 lesions [66.7%]; III, 5 lesions [0.6%]); there was no significant difference in the late delayed bleeding rate among these groups (IIa, 2/76 [2.6%]; IIb, 5/137 [3.6%]; IIc and III, 25/608 [4.1%]; P = .953).Conclusions: There was no difference in the late delayed bleeding rate according to Forrest classification in second-look endoscopy after endoscopic resection for gastric neoplasm.