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01-04-2013

Predictive risk factors of perforation in gastric endoscopic submucosal dissection for early gastric cancer: a large, multicenter study

Authors: Min Kim, Seong Woo Jeon, Kwang Bum Cho, Kyung Sik Park, Eun Soo Kim, Chang Keun Park, Hyang Eun Seo, Yun Jin Chung, Joong Goo Kwon, Jin Tae Jung, Eun Young Kim, Byeong Ik Jang, Si Hyung Lee, Kyeong Ok Kim, Chang Hun Yang, Daegu-Kyungpook Gastrointestinal Study Group (DGSG)

Published in: Surgical Endoscopy | Issue 4/2013

Abstract

Background

Although endoscopic submucosal dissection (ESD) is standard therapy for early gastric cancer, the complication rate is unsatisfactory, with perforation as the major complication during ESD. There have been several reports regarding the complications of ESD for gastric tumor especially perforation; however, little is known about the predictors for complications in patients undergoing ESD. The purpose of this retrospective study was to determine the risk factors for perforation in patients with early gastric cancer during ESD.

Methods

Between February 2003 and May 2010, we performed ESD for 1,289 lesions in 1,246 patients at six tertiary academic hospitals in Daegu, Kyungpook, Korea. Patient-related variables (age, sex, and underlying disease), endoscopic-related variables (indication of ESD, lesion size, location, type, and mucosal ulceration), procedure-related variables (operation time, complete resection, and invasion of submucosa/vessel/lymph node), and the pathologic diagnosis were evaluated as potential risk factors.

Results

The mean age of the patients was 64 years. The mean size of the endoscopic lesion was 19.4 mm. The overall en bloc resection rate was 93.3 %. Perforation (microperforation and macroperforation) was seen in 35 lesions. The location of the lesion (long axis: body/short axis: greater and lesser curvature) and piecemeal resection were associated with perforation (p = 0.01/0.047 and p = 0.049). Upon multivariate analysis, the location (body vs. antrum) of the lesion (odds ratio (OR) 2.636; 95 % confidence interval (CI) 1.319–5.267; p = 0.006) and piecemeal resection (OR 2.651; 95 % CI 1.056–6.656; p = 0.038) were significant predictive factors for perforation.

Conclusions

The result of this study demonstrated that the location of the lesion (body) and piecemeal resection were related to perforation during ESD.

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Title: Predictive risk factors of perforation in gastric endoscopic submucosal dissection for early gastric cancer: a large, multicenter study
Authors: Min Kim
Seong Woo Jeon
Kwang Bum Cho
Kyung Sik Park
Eun Soo Kim
Chang Keun Park
Hyang Eun Seo
Yun Jin Chung
Joong Goo Kwon
Jin Tae Jung
Eun Young Kim
Byeong Ik Jang
Si Hyung Lee
Kyeong Ok Kim
Chang Hun Yang
Daegu-Kyungpook Gastrointestinal Study Group (DGSG)
Publication date: 01-04-2013
Publisher: Springer-Verlag
Published in: Surgical Endoscopy / Issue 4/2013
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-012-2618-4

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Predictive risk factors of perforation in gastric endoscopic submucosal dissection for early gastric cancer: a large, multicenter study

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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