Inspection using magnifying endoscopy may facilitate identification of the vessels to prevent delayed bleeding after gastric endoscopic submucosal dissection

Objectives: The purpose of this study was to evaluate whether inspection of the post-endoscopic submucosal dissection (ESD) ulcer using magnifying endoscopy (ME) could improve identification of the vessels, thereby facilitating the prophylactic management to prevent delayed bleeding after gastric ESD.
Methods: This retrospective study included 160 patients who underwent gastric ESD for early gastric cancer from January 2024 to September 2024 in our center. In the control group, the post-ESD ulcer was inspected with standard mode. In the ME group, after the inspection with standard mode, the post-ESD ulcer was searched via low-magnification mode of the ME. For any visible vessels, prophylactic coagulation or clipping was performed. Delayed bleeding events after gastric ESD were compared between the two groups.
Results: Of the 160 patients, 126 underwent standard inspection (control group) and 34 underwent ME inspection (ME group). The baseline characteristics of the two groups were comparable. Delayed bleeding was less in the ME group than in the control group, while the difference was not significant (0% vs. 3.2%; P = 0.579). In the ME group, visible vessels were noted in 14 cases that had not been found in the standard mode.
Conclusions: Inspection using magnifying endoscopy may facilitate identification of the vessels to prevent delayed bleeding after gastric endoscopic submucosal dissection.