教員業績データベース |
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論文種別 | 原著 |
言語種別 | 英語 |
査読の有無 | 査読あり |
表題 | Clinical outcomes and risk factors for perforation in gastric endoscopic submucosal dissection: A prospective pilot study. |
掲載誌名 | 正式名:World journal of gastrointestinal endoscopy 略 称:World JGastrointest Endosc ISSNコード:1948-5190(Electronic) |
巻・号・頁 | 5(6),pp.281-7 |
著者・共著者 | Watari Jiro, Tomita Toshihiko, Toyoshima Fumihiko, Sakurai Jun, Kondo Takashi, Asano Haruki, Yamasaki Takahisa, Okugawa Takuya, Ikehara Hisatomo, Oshima Tadayuki, Fukui Hirokazu, Miwa Hiroto |
発行年月 | 2013/06 |
概要 | AIM:To evaluate clinical outcomes and risk factors for endoscopic perforation during endoscopic submucosal dissection (ESD) in a prospective study.METHODS:We investigated the clinical outcomes and risk factors for the development of perforation in 98 consecutive gastric neoplasms undergoing ESD regarding. Demographic and clinical parameters including patient-, tumor-, and treatment-related factors, clinical parameters, and duration of hospital stay were analyzed for risk factors for perforation. In subgroup analysis, we also compared the clinical outcomes between perforation andMETHODS:"METHODS:silentMETHODS:"METHODS:free air without endoscopically visible perforation detected only by computed tomography.RESULTS:Perforation was identified in 8.2% of patients. All patients were managed conservatively by the administration of antibiotics. The mean procedure time was significantly longer in patients with endoscopic perforation than in those without. According to the receiver-operating characteristic analysis, the resulting cutoff value of the procedure time for perforation was 115 min (87.5% sensitivity, 56.7% specificity). ProlongedRESULTS:procedure time (≥ 115 min) was associated with an increased risk of perforation (odds ratio 9.15; 95%CI: 1.08-77.54; P = 0.04). Following ESD, body temperature and C-reactive protein level were significantly higher in patients with perforation than in those without (P = 0.02), whereas there was no difference between these patient groups on the starting day of oral intake or of hospitalization. In subgroup analysis, the post-ESD clinical course was not different between endoscopic perforation and silent free air.CONCLUSION:Only prolonged procedure time (≥ 115 min) was significantly associated with perforation. The clinical outcomes of perforation are favorable and are comparable to those of patients with or without silent free air. |
DOI | wjge.v5.i6.281 |
文献番号 | 23772265 |