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Management of Bleeding in Advanced Endoscopic Procedures

Endoscopic mucosal resection and endoscopic submucosal dissection are used for the treatment of early gastrointestinal tract cancers. Bleeding is one of the most common complications encountered when performing these procedures. It is more common in gastric cases than in esophageal and colorectal cases. It is important to take measures before, during and after the procedure to mitigate the risk of bleeding. Patient history should be carefully questioned for bleeding tendency, the use of medications which may potentiate bleeding and the presence of a condition known to increase the risk of bleeding. In the case of bleeding during the procedure, a knife, coagrasper, hot biopsy forceps or hemoclip may be used. Although bleeding is a common complication in advanced endoscopic procedures, it can be easily managed in experienced hands and effective intervention methods.