Clinical Factors of Delayed Perforation after Endoscopic Submucosal Dissection for Gastric Neoplasms
Background. Delayed perforation is a rare but severe complication of endoscopic submucosal dissection (ESD) for early gastric neoplasm (EGN). The aim of this study was to clarify clinical factors related to delayed perforation after ESD. Methods. A total of 1158 consecutive patients with 1199 EGNs u...
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| Format: | Article |
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Wiley
2017-01-01
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| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2017/7404613 |
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| author | Yoshinobu Yamamoto Hogara Nishisaki Hideki Sakai Nagahiro Tokuyama Hiroaki Sawai Aya Sakai Takuya Mimura Saeko Kushida Hidetaka Tsumura Takeshi Sakamoto Ikuya Miki Masahiro Tsuda Hideto Inokuchi |
| author_facet | Yoshinobu Yamamoto Hogara Nishisaki Hideki Sakai Nagahiro Tokuyama Hiroaki Sawai Aya Sakai Takuya Mimura Saeko Kushida Hidetaka Tsumura Takeshi Sakamoto Ikuya Miki Masahiro Tsuda Hideto Inokuchi |
| author_sort | Yoshinobu Yamamoto |
| collection | DOAJ |
| description | Background. Delayed perforation is a rare but severe complication of endoscopic submucosal dissection (ESD) for early gastric neoplasm (EGN). The aim of this study was to clarify clinical factors related to delayed perforation after ESD. Methods. A total of 1158 consecutive patients with 1199 EGNs underwent ESD at our hospital between January 2000 and December 2015. Univariate analysis was used to identify clinicopathological factors related to delayed perforation. Moreover, duration of cautery needed for hemostasis was measured by comparison between perforated and nonperforated points in patients with delayed perforation. Results. Delayed perforation occurred in 5 of 1158 consecutive patients with 1199 EGNs who underwent ESD (0.42%). All cases were diagnosed within 24 h after ESD and recovered with conservative management. On univariate analysis, location in the upper stomach was the factor most significantly associated with delayed perforation (P<0.01). Duration of cautery needed for hemostasis was significantly longer at perforated points (9 s) than at nonperforated points (3.5 s) in five patients. Conclusions. Location in the upper stomach was the risk factor most prominently associated with delayed perforation after ESD for EGNs. In addition, delayed perforation appears associated with excessive electrocautery for hemostasis. |
| format | Article |
| id | doaj-art-286955703f6e423bb52adc2e4957fbd3 |
| institution | Kabale University |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Gastroenterology Research and Practice |
| spelling | doaj-art-286955703f6e423bb52adc2e4957fbd32025-02-03T01:11:05ZengWileyGastroenterology Research and Practice1687-61211687-630X2017-01-01201710.1155/2017/74046137404613Clinical Factors of Delayed Perforation after Endoscopic Submucosal Dissection for Gastric NeoplasmsYoshinobu Yamamoto0Hogara Nishisaki1Hideki Sakai2Nagahiro Tokuyama3Hiroaki Sawai4Aya Sakai5Takuya Mimura6Saeko Kushida7Hidetaka Tsumura8Takeshi Sakamoto9Ikuya Miki10Masahiro Tsuda11Hideto Inokuchi12Department of Gastroenterology, Hyogo Cancer Center, Hyogo 673-8558, JapanDepartment of Internal Medicine, Kaibara hospital, Hyogo 669-3395, JapanDepartment of Gastroenterology, Hyogo Cancer Center, Hyogo 673-8558, JapanDepartment of Gastroenterology, Hyogo Cancer Center, Hyogo 673-8558, JapanDepartment of Gastroenterology, Hyogo Cancer Center, Hyogo 673-8558, JapanDepartment of Gastroenterology, Hyogo Cancer Center, Hyogo 673-8558, JapanDepartment of Gastroenterology, Hyogo Cancer Center, Hyogo 673-8558, JapanDepartment of Gastroenterology, Hyogo Cancer Center, Hyogo 673-8558, JapanDepartment of Gastroenterology, Hyogo Cancer Center, Hyogo 673-8558, JapanDepartment of Gastroenterology, Hyogo Cancer Center, Hyogo 673-8558, JapanDepartment of Gastroenterology, Hyogo Cancer Center, Hyogo 673-8558, JapanDepartment of Gastroenterology, Hyogo Cancer Center, Hyogo 673-8558, JapanDepartment of Gastroenterology, Hyogo Cancer Center, Hyogo 673-8558, JapanBackground. Delayed perforation is a rare but severe complication of endoscopic submucosal dissection (ESD) for early gastric neoplasm (EGN). The aim of this study was to clarify clinical factors related to delayed perforation after ESD. Methods. A total of 1158 consecutive patients with 1199 EGNs underwent ESD at our hospital between January 2000 and December 2015. Univariate analysis was used to identify clinicopathological factors related to delayed perforation. Moreover, duration of cautery needed for hemostasis was measured by comparison between perforated and nonperforated points in patients with delayed perforation. Results. Delayed perforation occurred in 5 of 1158 consecutive patients with 1199 EGNs who underwent ESD (0.42%). All cases were diagnosed within 24 h after ESD and recovered with conservative management. On univariate analysis, location in the upper stomach was the factor most significantly associated with delayed perforation (P<0.01). Duration of cautery needed for hemostasis was significantly longer at perforated points (9 s) than at nonperforated points (3.5 s) in five patients. Conclusions. Location in the upper stomach was the risk factor most prominently associated with delayed perforation after ESD for EGNs. In addition, delayed perforation appears associated with excessive electrocautery for hemostasis.http://dx.doi.org/10.1155/2017/7404613 |
| spellingShingle | Yoshinobu Yamamoto Hogara Nishisaki Hideki Sakai Nagahiro Tokuyama Hiroaki Sawai Aya Sakai Takuya Mimura Saeko Kushida Hidetaka Tsumura Takeshi Sakamoto Ikuya Miki Masahiro Tsuda Hideto Inokuchi Clinical Factors of Delayed Perforation after Endoscopic Submucosal Dissection for Gastric Neoplasms Gastroenterology Research and Practice |
| title | Clinical Factors of Delayed Perforation after Endoscopic Submucosal Dissection for Gastric Neoplasms |
| title_full | Clinical Factors of Delayed Perforation after Endoscopic Submucosal Dissection for Gastric Neoplasms |
| title_fullStr | Clinical Factors of Delayed Perforation after Endoscopic Submucosal Dissection for Gastric Neoplasms |
| title_full_unstemmed | Clinical Factors of Delayed Perforation after Endoscopic Submucosal Dissection for Gastric Neoplasms |
| title_short | Clinical Factors of Delayed Perforation after Endoscopic Submucosal Dissection for Gastric Neoplasms |
| title_sort | clinical factors of delayed perforation after endoscopic submucosal dissection for gastric neoplasms |
| url | http://dx.doi.org/10.1155/2017/7404613 |
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