Predictive Factors for the Outcome of Unsupervised Endoscopic Submucosal Dissection During the Initial Learning Curve with Prevalence-Based Indication.
ESD
Education
Endoscopic resection
Endoscopic submucosal dissection
Endoscopy
Learning curve
Journal
Digestive diseases and sciences
ISSN: 1573-2568
Titre abrégé: Dig Dis Sci
Pays: United States
ID NLM: 7902782
Informations de publication
Date de publication:
09 2023
09 2023
Historique:
received:
11
02
2023
accepted:
26
06
2023
medline:
24
8
2023
pubmed:
8
7
2023
entrez:
8
7
2023
Statut:
ppublish
Résumé
For an adequate educational strategy of ESD in non-Asian settings with prevalence-based indication it is essential to define adequate lesions, suitable for the beginner without on-site expert-supervision. We analyzed possible predictors for outcome parameters of effectiveness and safety during the initial learning curve. The first 120 ESDs of four operators (n = 480), performed between 2007 and 2020 in four tertiary hospitals, were enrolled. Uni-/multivariable regression analysis was done with sex, age, pretreated lesion, lesion size, organ, and organ-based localization as possible independent predictors for en bloc resection (EBR), complication, and resection speed. Rates of EBR, complication, and resection speed were 84.5%, 14.2%, and 6.20 (± 4.45) cm During the initial learning curve of an unsupervised ESD program with prevalence-based indication, pretreated lesions and colonic ESDs should be avoided. In contrast, lesion size and organ-based localizations have less predictive value for the outcome.
Sections du résumé
BACKGROUND
For an adequate educational strategy of ESD in non-Asian settings with prevalence-based indication it is essential to define adequate lesions, suitable for the beginner without on-site expert-supervision.
AIMS
We analyzed possible predictors for outcome parameters of effectiveness and safety during the initial learning curve.
METHODS
The first 120 ESDs of four operators (n = 480), performed between 2007 and 2020 in four tertiary hospitals, were enrolled. Uni-/multivariable regression analysis was done with sex, age, pretreated lesion, lesion size, organ, and organ-based localization as possible independent predictors for en bloc resection (EBR), complication, and resection speed.
RESULTS
Rates of EBR, complication, and resection speed were 84.5%, 14.2%, and 6.20 (± 4.45) cm
CONCLUSION
During the initial learning curve of an unsupervised ESD program with prevalence-based indication, pretreated lesions and colonic ESDs should be avoided. In contrast, lesion size and organ-based localizations have less predictive value for the outcome.
Identifiants
pubmed: 37421512
doi: 10.1007/s10620-023-08026-9
pii: 10.1007/s10620-023-08026-9
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3614-3624Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
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