. 2021 Nov 22;11(11):2160.

doi: 10.3390/diagnostics11112160.

A Nomogram for Predicting Laparoscopic and Endoscopic Cooperative Surgery during the Endoscopic Resection of Subepithelial Tumors of the Upper Gastrointestinal Tract

Shun-Wen Hsiao^{1

2}, Mei-Wen Chen^{3

4}, Chia-Wei Yang¹, Kuo-Hua Lin⁵, Yang-Yuan Chen^{1

2

6}, Chew-Teng Kor^{7

8}, Siou-Ping Huang¹, Hsu-Heng Yen^{1

9

10

11}

Affiliations

¹ Division of Gastroenterology, Changhua Christian Hospital, Changhua 500, Taiwan.
² Division of Gastroenterology, Yuanlin Christian Hospital, Changhua 500, Taiwan.
³ Department of Information Management, Chien-Kuo Technology University, Chunghua 500, Taiwan.
⁴ Department of Tumor Center, Changhua Christian Hospital, Changhua 500, Taiwan.
⁵ Department of General Surgery, Changhua Christian Hospital, Changhua 500, Taiwan.
⁶ Department of Hospitality Management, MingDao University, Changhua 500, Taiwan.
⁷ Big Data Center, Changhua Christian Hospital, Changhua 500, Taiwan.
⁸ Graduate Institute of Statistics and Information Science, National Changhua University of Education, Changhua 500, Taiwan.
⁹ General Education Center, Chienkuo Technology University, Changhua 500, Taiwan.
¹⁰ Department of Electrical Engineering, Chung Yuan Christian University, Taoyuan 320, Taiwan.
¹¹ College of Medicine, National Chung Hsing University, Taichung 400, Taiwan.

PMID: 34829507
PMCID: PMC8624280
DOI: 10.3390/diagnostics11112160

A Nomogram for Predicting Laparoscopic and Endoscopic Cooperative Surgery during the Endoscopic Resection of Subepithelial Tumors of the Upper Gastrointestinal Tract

Shun-Wen Hsiao et al. Diagnostics (Basel). 2021.

. 2021 Nov 22;11(11):2160.

doi: 10.3390/diagnostics11112160.

Authors

Shun-Wen Hsiao^{1

2}, Mei-Wen Chen^{3

4}, Chia-Wei Yang¹, Kuo-Hua Lin⁵, Yang-Yuan Chen^{1

2

6}, Chew-Teng Kor^{7

8}, Siou-Ping Huang¹, Hsu-Heng Yen^{1

9

10

11}

Affiliations

¹ Division of Gastroenterology, Changhua Christian Hospital, Changhua 500, Taiwan.
² Division of Gastroenterology, Yuanlin Christian Hospital, Changhua 500, Taiwan.
³ Department of Information Management, Chien-Kuo Technology University, Chunghua 500, Taiwan.
⁴ Department of Tumor Center, Changhua Christian Hospital, Changhua 500, Taiwan.
⁵ Department of General Surgery, Changhua Christian Hospital, Changhua 500, Taiwan.
⁶ Department of Hospitality Management, MingDao University, Changhua 500, Taiwan.
⁷ Big Data Center, Changhua Christian Hospital, Changhua 500, Taiwan.
⁸ Graduate Institute of Statistics and Information Science, National Changhua University of Education, Changhua 500, Taiwan.
⁹ General Education Center, Chienkuo Technology University, Changhua 500, Taiwan.
¹⁰ Department of Electrical Engineering, Chung Yuan Christian University, Taoyuan 320, Taiwan.
¹¹ College of Medicine, National Chung Hsing University, Taichung 400, Taiwan.

PMID: 34829507
PMCID: PMC8624280
DOI: 10.3390/diagnostics11112160

Abstract

Background: Considering the widespread use of esophagogastroduodenoscopy, the prevalence of upper gastrointestinal (GI) subepithelial tumors (SET) increases. For relatively safer removal of upper GI SETs, endoscopic submucosal dissection (ESD) has been developed as an alternative to surgery. This study aimed to analyze the outcome of endoscopic resection for SETs and develop a prediction model for the need for laparoscopic and endoscopic cooperative surgery (LECS) during the procedure.

Method: We retrospectively analyzed 123 patients who underwent endoscopic resection for upper GI SETs between January 2012 and December 2020 at our institution. Intraoperatively, they underwent ESD or submucosal tunneling endoscopic resection (STER).

Results: ESD and STER were performed in 107 and 16 patients, respectively. The median age was 55 years, and the average tumor size was 1.5 cm. En bloc resection was achieved in 114 patients (92.7%). The median follow-up duration was 242 days without recurrence. Perforation occurred in 47 patients (38.2%), and 30 patients (24.4%) underwent LECS. Most perforations occurred in the fundus. Through multivariable analysis, we built a nomogram that can predict LECS requirement according to tumor location, size, patient age, and sex. The prediction model exhibited good discrimination ability, with an area under the curve (AUC) of 0.893.

Conclusions: Endoscopic resection is a noninvasive procedure for small upper-GI SETs. Most perforations can be successfully managed endoscopically. The prediction model for LECS requirement is useful in treatment planning.

Keywords: GIST; endoscopic resection; laparoscopy; subepithelial tumor.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

**Figure 1**
Nomogram of the prediction model.

**Figure 2**
ROC analysis for predicting LECS requirement during endoscopic resection.

**Figure 3**
Calibration plot for predicting LECS requirement during endoscopic resection.

See this image and copyright information in PMC

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A Nomogram for Predicting Laparoscopic and Endoscopic Cooperative Surgery during the Endoscopic Resection of Subepithelial Tumors of the Upper Gastrointestinal Tract

Affiliations

A Nomogram for Predicting Laparoscopic and Endoscopic Cooperative Surgery during the Endoscopic Resection of Subepithelial Tumors of the Upper Gastrointestinal Tract

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

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References

Grants and funding

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