A Nomogram for Predicting Laparoscopic and Endoscopic Cooperative Surgery during the Endoscopic Resection of Subepithelial Tumors of the Upper Gastrointestinal Tract
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 st...
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| Format: | Article |
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MDPI AG
2021-11-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/11/11/2160 |
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| author | Shun-Wen Hsiao Mei-Wen Chen Chia-Wei Yang Kuo-Hua Lin Yang-Yuan Chen Chew-Teng Kor Siou-Ping Huang Hsu-Heng Yen |
| author_facet | Shun-Wen Hsiao Mei-Wen Chen Chia-Wei Yang Kuo-Hua Lin Yang-Yuan Chen Chew-Teng Kor Siou-Ping Huang Hsu-Heng Yen |
| author_sort | Shun-Wen Hsiao |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-10T05:34:38Z |
| format | Article |
| id | doaj.art-9e3721114e334693af76aac94c85c222 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-10T05:34:38Z |
| publishDate | 2021-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-9e3721114e334693af76aac94c85c2222023-11-22T23:03:14ZengMDPI AGDiagnostics2075-44182021-11-011111216010.3390/diagnostics11112160A Nomogram for Predicting Laparoscopic and Endoscopic Cooperative Surgery during the Endoscopic Resection of Subepithelial Tumors of the Upper Gastrointestinal TractShun-Wen Hsiao0Mei-Wen Chen1Chia-Wei Yang2Kuo-Hua Lin3Yang-Yuan Chen4Chew-Teng Kor5Siou-Ping Huang6Hsu-Heng Yen7Division of Gastroenterology, Changhua Christian Hospital, Changhua 500, TaiwanDepartment of Information Management, Chien-Kuo Technology University, Chunghua 500, TaiwanDivision of Gastroenterology, Changhua Christian Hospital, Changhua 500, TaiwanDepartment of General Surgery, Changhua Christian Hospital, Changhua 500, TaiwanDivision of Gastroenterology, Changhua Christian Hospital, Changhua 500, TaiwanBig Data Center, Changhua Christian Hospital, Changhua 500, TaiwanDivision of Gastroenterology, Changhua Christian Hospital, Changhua 500, TaiwanDivision of Gastroenterology, Changhua Christian Hospital, Changhua 500, TaiwanBackground: 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.https://www.mdpi.com/2075-4418/11/11/2160subepithelial tumorendoscopic resectionlaparoscopyGIST |
| spellingShingle | Shun-Wen Hsiao Mei-Wen Chen Chia-Wei Yang Kuo-Hua Lin Yang-Yuan Chen Chew-Teng Kor Siou-Ping Huang Hsu-Heng Yen A Nomogram for Predicting Laparoscopic and Endoscopic Cooperative Surgery during the Endoscopic Resection of Subepithelial Tumors of the Upper Gastrointestinal Tract Diagnostics subepithelial tumor endoscopic resection laparoscopy GIST |
| title | A Nomogram for Predicting Laparoscopic and Endoscopic Cooperative Surgery during the Endoscopic Resection of Subepithelial Tumors of the Upper Gastrointestinal Tract |
| title_full | A Nomogram for Predicting Laparoscopic and Endoscopic Cooperative Surgery during the Endoscopic Resection of Subepithelial Tumors of the Upper Gastrointestinal Tract |
| title_fullStr | A Nomogram for Predicting Laparoscopic and Endoscopic Cooperative Surgery during the Endoscopic Resection of Subepithelial Tumors of the Upper Gastrointestinal Tract |
| title_full_unstemmed | A Nomogram for Predicting Laparoscopic and Endoscopic Cooperative Surgery during the Endoscopic Resection of Subepithelial Tumors of the Upper Gastrointestinal Tract |
| title_short | A Nomogram for Predicting Laparoscopic and Endoscopic Cooperative Surgery during the Endoscopic Resection of Subepithelial Tumors of the Upper Gastrointestinal Tract |
| title_sort | nomogram for predicting laparoscopic and endoscopic cooperative surgery during the endoscopic resection of subepithelial tumors of the upper gastrointestinal tract |
| topic | subepithelial tumor endoscopic resection laparoscopy GIST |
| url | https://www.mdpi.com/2075-4418/11/11/2160 |
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