Can endoscopic submucosal dissection be safely performed in a smaller specialized clinic?

Table 1 Clinical characteristics and major complications of the endoscopic submucosal dissection patients

	Total	Esophagus	Stomach	Duodenum	Colorectum
Patients, n	873	59	681	4	129
Age (yr), mean (range)	69.9 (44-91)	68.0 (46-81)	70.9 (45-91)	65.5 (54-77)	65.9 (44-80)
Sex (male:female), n	549:324	52:7	408:273	2:2	87:42
Lesions, n	1047	64	850	4	129
Tumor size (mm), mean (range)	22.2 (2-150)	23 (4-46)	20.8 (2-150)	16.8 (9-31)	31.6 (2-92)
Tumor diagnosis and depth, n
Benign tumor	121	0	86	0	35
Cancer (m)	808	56	668	4	80
Cancer (sm1)	61	4	48	0	9
Cancer (sm2 or deeper)	57	4	48	0	5
En bloc resection rate, %	94.3	96.9	95.8	100	79.8
Operation time (min), mean (range)	46 (4-360)	62 (48-206)	42 (4-360)	90 (50-114)	60 (7-300)
Complications associated with ESD, n (%)
Perforation	12 (1.1)	1 (1.7)	9 (1.1)	1 (25.0)	1 (0.8)
Postoperative bleeding	53 (5.1)	0 (0.0)	51 (6.0)	1 (25.0)	1 (0.8)

ESD: Endoscopic submucosal dissection.

Table 2 Operation times and tumor sizes in the cases with and those without complications (mean ± SD)

	Number of lesions	Size of treated lesions (mm)	Operation time (min)
Esophagus
All lesions	64	23.0 ± 11.0	76.4 ± 45.4
No complication	58	23.0 ± 11.1	76.4 ± 45.7
Complication
Perforation	1	24	57
Postoperative bleeding	0	ND	ND
Stomach
All lesions	850	20.2 ± 13.4	63.2 ± 47.2
No complication	791	19.9 ± 13.2	62.1 ± 46.9
Complication
Perforation	8	31.7 ± 14.7a	108.9 ± 45.7a
Postoperative bleeding	51	23.5 ± 15.5	73.1 ± 47.9a
Duodenum
All lesions	4	16.8 ± 10.1	94.5 ± 29.9
No complication	2	20.0 ± 15.6	112.0 ± 2.8
Complication
Perforation	1	10	104
Postoperative bleeding	1	17	50
Colorectum
All lesions	129	31.6 ± 16.5	86.6 ± 66.4
No complication	127	31.3 ± 16.4	84.5 ± 64.5
Complication
Perforation	1	35	135
Postoperative bleeding	1	65	300

^aP < 0.05 vs no complication group. ND: No data.