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

Title
Predictive risk factors of perforation in gastric endoscopic submucosal dissection for early gastric cancer: a large, multicenter study
Author(s)
장병익김민[김민]전성우[전성우]조광범[조광범]박경식[박경식]김은수[김은수]박창근[박창근]서향은[서향은]정윤진[정윤진]권중구[권중구]정진태[정진태]김은영[김은영]이시형김경옥양창헌[양창헌]
Keywords
CIRCUMFERENTIAL MUCOSAL INCISION; NONSURGICAL MANAGEMENT; EPITHELIAL NEOPLASMS; LEARNING-CURVE; RESECTION; EMR; LESIONS
Issue Date
201304
Publisher
SPRINGER
Citation
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, v.27, no.4, pp.1372 - 1378
Abstract
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. 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. 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. The result of this study demonstrated that the location of the lesion (body) and piecemeal resection were related to perforation during ESD.
URI
http://hdl.handle.net/YU.REPOSITORY/26103http://dx.doi.org/10.1007/s00464-012-2618-4
ISSN
0930-2794
Appears in Collections:
의과대학 > 내과학교실 > Articles
Files in This Item:
There are no files associated with this item.
Export
RIS (EndNote)
XLS (Excel)
XML


qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

BROWSE