Complications of endoscopic submucosal dissection for gastric noninvasive neoplasia: an analysis of 647 lesions.
OBJECTIVE
This study aimed to determine risk factors for postoperative complications of gastric endoscopic submucosal dissection (ESD).


METHODS
This retrospective study included 647 lesions in 580 consecutive patients who underwent ESD for gastric noninvasive neoplasia from January 1, 2002 through December 31, 2011.


RESULTS
The overall perforation rate was 5.1%. Multivariate logistic regression analysis indicated that perforation was significantly associated with tumors in the greater curvature of the stomach (P<0.0001), scars in tumor lesions (P=0.002), long operative time (P=0.007), and tumors in the remnant stomach (P=0.036). The bleeding rate after gastric ESD was 3.9%. Multivariate logistic regression analysis indicated a statistically significant association between postoperative bleeding and oral anticoagulant or antiplatelet drugs (P<0.0001), dialysis (P=0.009), and use of antihypertensive drugs (P=0.015).


CONCLUSIONS
It is important to perform gastric ESD with particular care in patients with risk factors.
Second Department of Surgery, School of Medicine, Wakayama Medical University, Wakayama, Japan.
Toshiyasu
T
Ojima
Katsunari
K
Takifuji
Masaki
M
Nakamura
Makoto
M
Iwahashi
Mikihito
M
Nakamori
Masahiro
M
Katsuda
Takeshi
T
Iida
Keiji
K
Hayata
Hiroki
H
Yamaue
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004210:Dissection / Q000009:adverse effects*; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate / Q000639:trends