Risk factors of procedure time of endoscopic submucosal dissection for esophageal lesions

中华消化内镜杂志 Pub Date : 2019-10-20 DOI:10.3760/CMA.J.ISSN.1007-5232.2019.10.002

Xiao Li, Min Zhu

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Abstract

Objective To investigate risk factors of procedure time of endoscopic submucosal dissection (ESD) for treatment of esophageal lesions. Methods A total of 160 patients with single esophageal lesion who underwent ESD at department of gastroenterology, Beijing Friendship Hospital from January 2015 to October 2017 were enrolled. Medical information including general information (age and gender), and lesion’s characteristics (location, size, gross morphology, pathological type, differentiation degree, and depth of invasion), operators’experience, circumferential resection size, operation and anesthesia time were retrospectively collected. According to the operation time, the cases were divided into the long-term operation group (exceeded 120 min) and the short-time operation group (less than 120 min). The factors affecting the esophageal ESD operation time were analyzed by univariate and multivariate analysis. Results Among the 160 patients, 120 (75.0%) were men and 40 (25.0%) were women. The age was 62.65±8.48 years. The median (interquartile range) size of lesion was 1.70 (1.00, 2.65) cm. The median time of ESD was 113.54 (81.25, 168.75) min. Univariate analysis showed that age >65 years, the lesions of type Ⅱa+ Ⅱc/Ⅱc, lesion size >2 cm and >1/2 esophageal circumference resection were associated with a longer ESD operation time (P 0.05). Multivariate analysis showed that the type Ⅱa+ Ⅱc/Ⅱc (OR=2.47, 95%CI: 1.01-6.06, P=0.047), lesion size>2 cm (OR=3.41, 95%CI: 1.34-8.64, P=0.010) and > 1/2 esophageal circumference resection (OR=4.24, 95%CI: 1.62-11.11, P=0.030) were independent risk factors for the operation time of longer than 120 min. Conclusion Type Ⅱa+ Ⅱc/Ⅱc lesions, the lesion size >2 cm and the resection area >1/2 esophageal circumference were independent risk factors for a prolonged operation time of esophageal ESD procedure. Key words: Risk factors; Early esophageal cancers; Endoscopic submucosal dissection; Procedure time

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食管病变内镜下黏膜下剥离术时间的危险因素

目的探讨内镜下粘膜下剥离术(ESD)治疗食管病变手术时间的影响因素。方法选取2015年1月至2017年10月在北京友谊医院消化科接受ESD治疗的160例单一食管病变患者。回顾性收集患者一般信息(年龄、性别)、病变特征(部位、大小、大体形态、病理类型、分化程度、浸润深度)、手术经验、环切大小、手术及麻醉时间等医疗信息。根据手术时间分为长期手术组(超过120 min)和短期手术组(小于120 min)。采用单因素和多因素分析分析影响食管ESD手术时间的因素。结果160例患者中，男性120例(75.0%)，女性40例(25.0%)。年龄62.65±8.48岁。病灶大小中位数(四分位间距)为1.70 (1.00,2.65)cm。ESD的中位时间为113.54 (81.25,168.75)min。单因素分析显示，年龄bbb65岁、病变类型为Ⅱa+Ⅱc/Ⅱc、病变大小>2 cm、切除>1/2食管周长与ESD手术时间延长相关(P < 0.05)。多因素分析显示:Ⅱa+Ⅱc/Ⅱc型(OR=2.47, 95%CI: 1.01 ~ 6.06, P=0.047)、病变大小>2 cm (OR=3.41, 95%CI: 1.34 ~ 8.64, P=0.010)、> 1/2食管周切除术(OR=4.24, 95%CI:1.62-11.11, P=0.030)是手术时间超过120 min的独立危险因素。结论Ⅱa+Ⅱc/Ⅱc病变类型、病变大小>2 cm、切除面积>1/2食管周长是延长食管ESD手术时间的独立危险因素。关键词:危险因素;早期食管癌;内镜下粘膜下剥离;手术时间

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来源期刊

中华消化内镜杂志

CiteScore

0.10

自引率

0.00%

发文量

7555

期刊介绍： Chinese Journal of Digestive Endoscopy is a high-level medical academic journal specializing in digestive endoscopy, which was renamed Chinese Journal of Digestive Endoscopy in August 1996 from Endoscopy. Chinese Journal of Digestive Endoscopy mainly reports the leading scientific research results of esophagoscopy, gastroscopy, duodenoscopy, choledochoscopy, laparoscopy, colorectoscopy, small enteroscopy, sigmoidoscopy, etc. and the progress of their equipments and technologies at home and abroad, as well as the clinical diagnosis and treatment experience. The main columns are: treatises, abstracts of treatises, clinical reports, technical exchanges, special case reports and endoscopic complications. The target readers are digestive system diseases and digestive endoscopy workers who are engaged in medical treatment, teaching and scientific research. Chinese Journal of Digestive Endoscopy has been indexed by ISTIC, PKU, CSAD, WPRIM.