Risk factors influencing operating efficiency of endoscopic submucosal dissection for gastric mucosal lesions

Abstract

Objective To explore risk factors of influencing operating efficiency of endoscopic submucosal dissection (ESD) for gastric mucosal lesions. Methods The data of 304 cases with gastric mucosal lesion undergoing ESD in Xijing Hospital of Digestive Disease from April 2009 to February 2017 were retrospectively analyzed. The procedure time and complete resection rate (R0 resection rate) were regarded as indicators of ESD efficiency. Risk factors influencing procedure time and R0 resection rate were analyzed using Chi-square test and logistic regression. Results Using median procedure time of 45 min as the cutoff value, Chi-square test showed that specimen size (P=0.000), lesion location (P=0.001), and pathological type (P=0.003) affected the operation time. Further logistic regression analysis indicated that specimen size (≥40 mm/<40 mm, P<0.001, OR=3.748, 95%CI: 2.247-6.254) and lesion location (upper or middle 1/3 of stomach/lower 1/3 of stomach, P=0.001, OR=2.180, 95%CI: 1.318-3.606) were independent risk factors of procedure time. Using R0 resection as outcome measure, neither single nor multiple parameter analysis was statistically significant. Conclusion Specimen size and lesion location are independent risk factors influencing efficiency of gastric mucosal ESD, and could be possibly used to estimate the procedure time of ESD. Key words: Endoscopes; Endoscopic submucosal dissection; Gastric mucosal lesion; Procedure time