Cai RS, Yang WZ, Cui GR. Associate factors for endoscopic submucosal dissection operation time and postoperative delayed hemorrhage of early gastric cancer. World J Gastrointest Surg 2023; 15(1): 94-104 [PMID: 36741071 DOI: 10.4240/wjgs.v15.i1.94]
Corresponding Author of This Article
Ren-Song Cai, BSc, MD, Attending Doctor, Digestive Endoscopy Department, the Second Affiliated Hospital of Hainan Medical University, No. 368 Yehai Avenue, Longhua District, Haikou 570311, Hainan Province, China. cairensong@126.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective 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 Surg. Jan 27, 2023; 15(1): 94-104 Published online Jan 27, 2023. doi: 10.4240/wjgs.v15.i1.94
Associate factors for endoscopic submucosal dissection operation time and postoperative delayed hemorrhage of early gastric cancer
Ren-Song Cai, Wei-Zhong Yang, Guang-Rui Cui
Ren-Song Cai, Wei-Zhong Yang, Guang-Rui Cui, Digestive Endoscopy Department, the Second Affiliated Hospital of Hainan Medical University, Haikou 570311, Hainan Province, China
Author contributions: Cai RS designed this study, analyzed the data and drafted the manuscript; Yang WZ and Cui GR collected the data and reviewed the manuscript critically; all authors have read and approved the final manuscript version.
Institutional review board statement: The study was reviewed and approved by Ethics Committee of the Second Affiliated Hospital of Hainan Medical University.
Informed consent statement: The data used in this study were not involved in the patients’ privacy information, so the informed consent was waived by the Ethics Committee of Second Affiliated Hospital of Hainan Medical University. All patient data obtained, recorded, and managed only used for this study, and all patient information are strictly confidential, without any harm to the patient.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
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: Ren-Song Cai, BSc, MD, Attending Doctor, Digestive Endoscopy Department, the Second Affiliated Hospital of Hainan Medical University, No. 368 Yehai Avenue, Longhua District, Haikou 570311, Hainan Province, China. cairensong@126.com
Received: November 14, 2022 Peer-review started: November 14, 2022 First decision: December 1, 2022 Revised: December 6, 2022 Accepted: December 23, 2022 Article in press: December 23, 2022 Published online: January 27, 2023 Processing time: 65 Days and 5.4 Hours
ARTICLE HIGHLIGHTS
Research background
Endoscopic submucosal dissection (ESD) has become a new development trend in the treatment of early gastric cancer due to its special minimally invasive advantages. Although it is minimally invasive surgery, it also has some risks such as bleeding and perforation.
Research motivation
The time of ESD operation is closely related to bleeding and perforation.
Research objectives
This study aims to investigate the operation time of endoscopic subspecific section and the influencing factors of delayed bleeding after operation.
Research methods
The baseline data, clinical features, and endoscopic and pathological characteristics of patients were collected. The multivariate linear regression model was used to investigate the influencing factors of ESD operation time. Logistic regression analysis was carried out to evaluate the influencing factors of postoperative delayed hemorrhage.
Research results
The maximum diameter of the lesion, lesion morphology, and ESD operation time were independent influencing factors for delayed hemorrhage after ESD. Patients with lesion ≥ 3.0 cm (OR = 3.785, 95%CI: 1.165-4.277), lesion morphology-concave (OR = 10.985, 95%CI: 2.133-35.381), and ESD operation time ≥ 60 min (OR = 2.958, 95%CI: 1.117-3.526) were prone to delayed hemorrhage after ESD.
Research conclusions
The risk of delayed bleeding after ESD is higher when the maximum diameter of the lesion is ≥ 3.0 cm, the lesion morphology is concave, and the ESD operation time is longer.
Research perspectives
Further research should be made on other factors related to delayed bleeding after ESD operation, such as factors during operation and individual related factors. Strict control of surgical indications and adherence to individualized treatment can help reduce the occurrence of complications.
