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Gastric Cancer
Published in: Gastric Cancer 4/2023

15-04-2023 | Gastrointestinal Stromal Tumor | Original Article

Risk factors of perforation in gastric stromal tumors during endoscopic resection: a retrospective case–control study

Authors: Muhan Ni, Dehua Tang, Wei Ren, Rui Meng, Jinping Yang, Peng Yan, Xiwei Ding, Guifang Xu, Ying Lv, Min Chen, Hua Yang, Lei Wang

Published in: Gastric Cancer | Issue 4/2023

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Abstract

Background and aims

Perforation is a common complication during endoscopic resection (ER) of gastric gastrointestinal stromal tumors (gGISTs) associated with secondary infections, sepsis, hospitalization time and cost. However, the risk factors of perforation remain controversial. This study aimed to investigate the risk factors for perforation during ER of gGISTs.

Methods

This retrospective case–control study included consecutive patients with gGISTs who underwent ER between June 2009 and November 2021 at the Nanjing Drum Tower Hospital. Univariate and multivariate analyses were performed to investigate the risk factors for perforation. Sensitivity analyses with propensity scoring (PS) were performed to evaluate the stability of the independent effects.

Results

In total, 422 patients with gGISTs were included. The following factors were associated with perforation during ER: in the non-intraluminal growth patterns (all confounders adjusted odds ratio [aOR]: 5.39, 95% CI 2.99–9.72, P < 0.001), in the gastric fundus (aOR 2.25, 95% CI 1.40–3.60, P = 0.007), sized ≥ 2 cm (aOR 1.70, 95% CI 1.04–2.77, P = 0.035), in the lesser curvature (aOR 0.12, 95% CI 0.05–0.27, P < 0.001), and in the gastric cardia (aOR 0.13, 95% CI 0.04–0.50, P = 0.003). The PS analysis confirmed the stable independent effects of these identified risk factors.

Conclusions

ERs of gGISTs in non-intraluminal growth patterns, in the gastric fundus, and with larger tumor size were independent risk factors for perforation. While tumors in the lesser curvature or gastric cardia were independent protective factor for perforation.
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Metadata
Title
Risk factors of perforation in gastric stromal tumors during endoscopic resection: a retrospective case–control study
Authors
Muhan Ni
Dehua Tang
Wei Ren
Rui Meng
Jinping Yang
Peng Yan
Xiwei Ding
Guifang Xu
Ying Lv
Min Chen
Hua Yang
Lei Wang
Publication date
15-04-2023
Publisher
Springer Nature Singapore
Published in
Gastric Cancer / Issue 4/2023
Print ISSN: 1436-3291
Electronic ISSN: 1436-3305
DOI
https://doi.org/10.1007/s10120-023-01391-4

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