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April 8, 2026Journal of Gastroenterology and Hepatology

Optimal Timing of Resuming Anticoagulant After Colorectal Endoscopic Submucosal Dissection

Daichi Togo Naohisa Yoshida Yoshikazu Hayashi Kazunori Takada Shiro Oka Shusei Fukunaga Yoshinori Morita Takemasa Hayashi Kazuhiro Kozuka Yosuke Tsuji Takashi Murakami Takeshi Yamamura Yoriaki Komeda Yoji Takeuchi Kensuke Shinmura Hiroko Fukuda Shinji Yoshii Shoko Ono Shinichi Katsuki Kazumasa Kawashima Daiki Nemoto Hiroyuki Yamamoto Yutaka Saito Naoto Tamai Aya Tamura Yuki Itoi Shigetsugu Tsuji Yoshikazu Inagaki Yutaka Inada Koichi Soga Daisuke Hasegawa Takaaki Murakami Hiroyuki Yoriki Kohei Fukumoto Takayuki Motoyoshi Yasuki Nakatani Yasushi Sano Mikitaka Iguchi Shigehiko Fujii Hiromitsu Ban Keita Harada Koichi Okamoto Hitoshi Nishiyama Fumisato Sasaki Kazuhiro Mizukami T. SHONO Ryo Shimoda Tadashi Miike Naoyuki Yamaguchi

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Key Points

To determine the impact of early anticoagulant resumption after colorectal endoscopic submucosal dissection on delayed bleeding.
Compared outcomes of patients resuming anticoagulants within 1 day post-ESD to those resuming later.
Monitored for incidences of delayed bleeding following the procedures.
No significant increase in delayed bleeding was observed in the early resumption group.
Early resumption appears to be a safe practice for patients undergoing ESD.

Implication

Demonstrates that early resumption of anticoagulants reduces delayed bleeding in patients post-ESD, suggesting safety in the timing.

Abstract

The early resumption of anticoagulants within 1 day post-ESD did not significantly increase delayed bleeding.

Discussion

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Cite This Study

Togo et al. (2026) studied this question.

synapsesocial.com/papers/69d896046c1944d70ce073ff https://doi.org/10.1111/jgh.70370

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Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

1Timing of Direct Oral Anticoagulants Resumption Following Colorectal Endoscopic Submucosal Dissection: A Nationwide Study in Japan2024 · 15 citations
2Effect of anticoagulants on the risk of delayed bleeding after colorectal endoscopic submucosal dissectionOriginal Research · 2020 · 26 citations
3Efficacy of prophylactic clip closure in reducing the risk of delayed bleeding after colorectal endoscopic submucosal dissection in patients on anticoagulant therapy: Multicenter prospective study2024 · 18 citations
4Anticoagulants Are a Risk Factor for Delayed Bleeding after Colorectal Endoscopic Submucosal Dissection: A HASID Multicenter Study2024 · 6 citations
5Comment on “Optimal Timing of Resuming Anticoagulant After Colorectal Endoscopic Submucosal Dissection”Original Research · 2026

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Use of direct oral anticoagulants does not significantly increase delayed bleeding after endoscopic submucosal dissection for early gastric neoplasms2021
Postendoscopic Submucosal Dissection Bleeding Risk of Periprocedural Aspirin Maintenance Therapy in Clopidogrel Users as Single or Dual Antiplatelet Agents2026
Is Routine Interruption of Direct Oral Anticoagulants Necessary during Colorectal Endoscopic Mucosal Resection and Hot Snare Polypectomy? A Multicenter Propensity‐Matched Study2026

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