Switching from endoscopic submucosal dissection to salvage piecemeal knife-assisted snare resection to remove a lesion: a preoperative risk score from the beginning
Rev. esp. enferm. dig
; 110(11): 699-705, nov. 2018. tab, graf
Article
em En
| IBECS
| ID: ibc-177908
Biblioteca responsável:
ES1.1
Localização: BNCS
ABSTRACT
Background and aims:
endoscopic submucosal dissection (ESD) in the Western setting remains a challenge. Therefore, other simplified techniques such as knife-assisted snare resection (KAR) have been reported to overcome this issue.Methods:
patients who underwent an ESD for the treatment of gastrointestinal neoplasms were included in a retrospective cross-sectional observational study. Factors associated with the end of ESD as a salvage p-KAR were identified and a logistic regression model was developed.Results:
a total of 136 lesions in 133 patients were analyzed. Operator experience of under 50 cases and the combination of lesion size > 30 mm and colorectal location were independent predictive factors for switching to a salvage p-KAR according to the multivariate logistic regression analysis. We developed a risk scoring system based on these four variables (experience, size, location and the combination of size and location) with a receiver operating characteristic curve of 0.81 (95% CI 0.74-0.89). The diagnostic accuracy of the score for a cut-off point ≥ 5 had a sensitivity of 0.79 (95% CI 0.66-0.93) and a specificity of 0.71 (95% CI 0.61-0.80).Conclusion:
a simple predictive score system that includes four preoperative factors accurately predicts ESD to finish as a p-KAR. A careful selection of cases considering these variables could be useful to achieve better outcomes in the Westernsetting:
RESUMEN
No disponible
Texto completo:
1
Coleções:
06-national
/
ES
Base de dados:
IBECS
Assunto principal:
Neoplasias Gástricas
/
Neoplasias Colorretais
/
Ressecção Endoscópica de Mucosa
Limite:
Humans
Idioma:
En
Revista:
Rev. esp. enferm. dig
Ano de publicação:
2018
Tipo de documento:
Article