胃非侵袭性肿瘤内镜黏膜下剥离术的并发症：647例病变分析
Complications of endoscopic submucosal dissection for gastric noninvasive neoplasia: an analysis of 647 lesions.
作者信息
Ojima Toshiyasu, Takifuji Katsunari, Nakamura Masaki, Iwahashi Makoto, Nakamori Mikihito, Katsuda Masahiro, Iida Takeshi, Hayata Keiji, Yamaue Hiroki
机构信息
Second Department of Surgery, School of Medicine, Wakayama Medical University, Wakayama, Japan.
出版信息
Surg Laparosc Endosc Percutan Tech. 2014 Aug;24(4):370-4. doi: 10.1097/SLE.0b013e318290132e.
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.
目的
本研究旨在确定胃内镜黏膜下剥离术（ESD）术后并发症的危险因素。
方法
这项回顾性研究纳入了2002年1月1日至2011年12月31日期间连续580例因胃非侵袭性肿瘤接受ESD治疗的患者的647个病变。
结果
总体穿孔率为5.1%。多因素逻辑回归分析表明，穿孔与胃大弯处肿瘤（P<0.0001）、肿瘤病变中的瘢痕（P=0.002）、手术时间长（P=0.007）以及残胃肿瘤（P=0.036）显著相关。胃ESD术后出血率为3.9%。多因素逻辑回归分析表明，术后出血与口服抗凝药或抗血小板药物（P<0.0001）、透析（P=0.009）以及使用降压药（P=0.015）之间存在统计学上的显著关联。
结论
对于有危险因素的患者，谨慎进行胃ESD很重要。
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