Predictors for operation time of endoscopic submucosal dissection for superficial gastric lesions / 中华消化内镜杂志

ABSTRACT

Objective@#To investigate the risk factors of operation time of endoscopic submucosal dissection (ESD) for superficial gastric lesions.@*Methods@#Clinicopathologic data of 193 patients (195 lesions) diagnosed with early gastric cancer preoperatively who received ESD in Beijing Friendship Hospital from January 2015 to December 2017 were retrospectively collected, including basic information (age, gender, body mass index, comorbidities), lesion characteristics (size, location, morphology), the operators′ experience of ESD, operation time, and postoperative pathology, etc. Univariate analysis was performed to find the risk factors of ESD operation time, and logistic regression analysis was performed on the factors with statistical differences in univariate analysis to find the independent risk factors of ESD operation time over 120 min.@*Results@#The mean age of the patients was 63.34±9.11 years. The median time of ESD operation was 120.00 (95.00, 165.00) min and the median size of the lesions was 1.50 (1.00, 2.38) cm. Early gastric cancer was diagnosed by postoperative pathology in 164 lesions (84.10%), among which 162 lesions (98.78%) achieved en bloc resection, and 148 lesions (90.24%) achieved curative resection. The gender (P=0.018), location(P<0.001) and size (r=0.209, P=0.007) were risk factors of the operation time by univariate analysis, while age, body mass index, American Society of Anesthesiologists (ASA) grade, roughness of lesion surface, presence or absence of white moss and ulcer, depth of lesion invasion, operative period, gross shape of lesion, degree of differentiation, and experience of operator were not associated with operation time (all P>0.05). Multivariate analysis showed that the lesion located in cardia/fundus of stomach (OR=5.656, 95%CI 2.291-13.964, P<0.001), body of stomach (OR=2.667, 95%CI 1.048-6.785, P=0.040) and >2 cm in size (OR=2.761, 95%CI 1.229-6.205, P=0.014) were independent risk factors for the operation time longer than 120 min.@*Conclusion@#Lesions located in the cardia/fundus, body of stomach and >2 cm in size are independent risk factors for long operation time of ESD.