Yang J, Chen ZG, Yi XL, Chen J, Chen L. Nomogram to predict gas-related complications during transoral endoscopic resection of upper gastrointestinal submucosal lesions. World J Gastrointest Endosc 2023; 15(11): 649-657 [PMID: 38073760 DOI: 10.4253/wjge.v15.i11.649]
Corresponding Author of This Article
Lei Chen, MD, PhD, Professor, Department of Gastroenterology, The First Affiliated Hospital (Southwest Hospital) to Third Military Medical University (Army Medical University), Gaotanyan Street, Shapingba District, Chongqing 400038, China. chenlei_1977603@126.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Nov 16, 2023; 15(11): 649-657 Published online Nov 16, 2023. doi: 10.4253/wjge.v15.i11.649
Nomogram to predict gas-related complications during transoral endoscopic resection of upper gastrointestinal submucosal lesions
Jia Yang, Zhi-Guo Chen, Xing-Lin Yi, Jing Chen, Lei Chen
Jia Yang, Zhi-Guo Chen, Jing Chen, Lei Chen, Department of Gastroenterology, The First Affiliated Hospital (Southwest Hospital) to Third Military Medical University (Army Medical University), Chongqing 400038, China
Xing-Lin Yi, Department of Pulmonology, The First Affiliated Hospital (Southwest Hospital) to Third Military Medical University (Army Medical University), Chongqing 400038, China
Author contributions: Chen L conceived and designed this study; Yang J and Chen ZG collected and analyzed patient data; Yang J and Yi XL drafted and completed the manuscript; Yang J, Chen ZG, and Chen J prepared the tables and figures; and all authors are accountable for interpreting the data and revising the manuscript.
Supported byGan/University Talent Pool Cultivation Fund, No. XZ-2019-505-017.
Institutional review board statement: The First Affiliated Hospital Ethics Committee of the Army Medical University approved the study [Approval ID: (B) KY2023006].
Informed consent statement: All patients provided written informed consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The data supporting the results of this study are available from the corresponding author upon reasonable request.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lei Chen, MD, PhD, Professor, Department of Gastroenterology, The First Affiliated Hospital (Southwest Hospital) to Third Military Medical University (Army Medical University), Gaotanyan Street, Shapingba District, Chongqing 400038, China. chenlei_1977603@126.com
Received: September 5, 2023 Peer-review started: September 5, 2023 First decision: September 13, 2023 Revised: September 21, 2023 Accepted: October 16, 2023 Article in press: October 16, 2023 Published online: November 16, 2023 Processing time: 65 Days and 15.5 Hours
Abstract
BACKGROUND
Gas-related complications present a potential risk during transoral endoscopic resection of upper gastrointestinal submucosal lesions. Therefore, the identification of risk factors associated with these complications is essential.
AIM
To develop a nomogram to predict risk of gas-related complications following transoral endoscopic resection of the upper gastrointestinal submucosal lesions.
METHODS
We collected patient data from the First Affiliated Hospital of the Army Medical University. Patients were randomly allocated to training and validation cohorts. Risk factors for gas-related complications were identified in the training cohort using univariate and multivariate analyses. We then constructed a nomogram and evaluated its predictive performance based on the area under the curve, decision curve analysis, and Hosmer-Lemeshow tests.
RESULTS
Gas-related complications developed in 39 of 353 patients who underwent transoral endoscopy at our institution. Diabetes, lesion origin, surgical resection method, and surgical duration were incorporated into the final nomogram. The predictive capability of the nomogram was excellent, with area under the curve values of 0.841 and 0.906 for the training and validation cohorts, respectively.
CONCLUSION
The ability of our four-variable nomogram to efficiently predict gas-related complications during transoral endoscopic resection enhanced postoperative assessments and surgical outcomes.
Core Tip: This is a retrospective study to create a nomogram that efficiently evaluates the risk of gas-related complications in patients undergoing transoral endoscopic resection of upper gastrointestinal submucosal lessions. Our study excluded upper gastrointestinal malignancies and explored risk factors for gas-related complications during transoral endoscopic resection. Predictive models were developed based on diabetes status, lesion origin layer, operative resection technique, and duration of the operation.
