Complications of endoscopic submucosal dissection for gastric noninvasive neoplasia: an analysis of 647 lesions

Abstract

Purpose: This study aimed to determine risk factors for postoperative complications of gastric endoscopic submucosal dissection (ESD).

Methods: This retrospective study included 647 lesions in 580 consecutive patients who underwent ESD for gastric noninvasive neoplasia from January 1, 2002 through December 31, 2011.

Results: The overall perforation rate was 5.1%. Multivariate logistic regression analysis indicated that perforation was significantly associated with tumors in the greater curvature of the stomach (P<0.0001), scars in tumor lesions (P=0.002), long operative time (P=0.007), and tumors in the remnant stomach (P=0.036). The bleeding rate after gastric ESD was 3.9%. Multivariate logistic regression analysis indicated a statistically significant association between postoperative bleeding and oral anticoagulant or antiplatelet drugs (P<0.0001), dialysis (P=0.009), and use of antihypertensive drugs (P=0.015).

Conclusion: It is important to perform gastric ESD with particular care in patients with risk factors.