ESD technology can effectively improve the symptoms of EC. If the early is not effectively judged and managed, the prognosis of children may be poor. Through high-precision electron microscopy, it can effectively separate the tissue between the mucosal layer and the mucosal layer to remove the submucosal tumour effectively. Moreover, the defect of this method is that it has minor trauma, low cost, and a fast operation process [12]. However, the common postoperative complications include perforation, stenosis and delayed bleeding, which have a low incidence [13-14] and are often invisible and easily ignored by medical staff, thus seriously reducing the effectiveness of surgery and even leading to severe sequelae and endangering the survival of patients.
The morphology, function and treatment of early oesophagal cancer still need to be further studied, and the current diagnosis and treatment still rely on early diagnosis and stem cell transplantation technology. Although early diagnosis and stem cell transplantation can help patients with early-stage oesophagal cancer recover, the advantages of this technology cannot be ignored. As an advanced minimally invasive technology [15-18], ESD has become increasingly popular in clinical treatment, and its efficacy has been generally praised. However, it must pay more attention to the perforation, delayed postoperative bleeding and other side effects it brings. The control of intraoperative bleeding in ESD is significant. However, the control of postoperative delayed bleeding is more complex, and if it is not solved in time, it may lead to significant results and endanger the safety of patients [19-20].
Prolonged haemorrhage after ESD surgery may lead to severe sequelae and damage the patient's health. This condition can occur for many reasons and requires a comprehensive analysis to ensure effective prevention. According to our study, after 60 patients with early oesophagal cancer received ESD surgery, 18 had prolonged massive bleeding, accounting for the proportion reached. Through Logistic regression analysis, we can find that the proportion of patients over 50 years old, tumour diameter ≥3cm, and massive bleeding and infiltration during surgery are higher. Studies have shown that patients with early oesophagal cancer are prone to prolong massive bleeding after ESD surgery [21]. The principal risks of this condition are: (1) With age, the elasticity of blood vessels decreases, and blood vessels become stronger; (2) In addition, the tissue recovery ability of the elderly is weaker, and the wound healing will become more delayed, which will lead to the risk of delayed bleeding [22]. When the size of the tumour becomes more extensive, the complexity of the surgery will increase correspondingly, the scope of surgery will become more extensive, and the repair after surgery will become more delayed. In addition, because the wall of the oesophagus is relatively fragile and has sufficient blood, the risk of significant bleeding after surgery becomes higher [23-26]. Due to deficiencies in preoperative preparation, potential bleeding after surgery may be more easily overlooked. (4) With the invasion of cancer cells, there may be more potential bleeding after surgery. Therefore, preoperative preparation is critical to ensure timely control of potential bleeding after surgery [27-29]. If preoperative preparation is too poor, the probability of potential bleeding after surgery is easily ignored, so the quality and effect of preoperative preparation are crucial. Before the treatment of early oesophagal cancer, in order to reduce the risk of delayed bleeding [30-33], medical staff must assess the risk and carefully handle it during the operation, especially at the site of M3 lesions, to ensure that the postoperative treatment process is thorough and bleeding can be effectively controlled and blocked [34].
In summary, the incidence of delayed major bleeding in early esophageal cancer patients undergoing ESD surgery significantly increases, seriously hindering their postoperative recovery. Delayed major bleeding after ESD surgery may be related to factors such as age 50 years and younger, tumor diameter ≥3M, major bleeding during surgery, and degree of cancer cell invasion (m3). In order to reduce the occurrence of this situation, we strongly recommend that medical personnel perform a complete risk analysis of the above risk factors before ESD surgery, and adequately care for the wound during surgery, while taking appropriate antiplatelet drugs to reduce the occurrence of delayed bleeding.