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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Autores principales:	Shun-Wen Hsiao, Mei-Wen Chen, Chia-Wei Yang, Kuo-Hua Lin, Yang-Yuan Chen, Chew-Teng Kor, Siou-Ping Huang, Hsu-Heng Yen
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	subepithelial tumor endoscopic resection laparoscopy GIST Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/9e3721114e334693af76aac94c85c222
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spelling	oai:doaj.org-article:9e3721114e334693af76aac94c85c2222021-11-25T17:22:09ZA Nomogram for Predicting Laparoscopic and Endoscopic Cooperative Surgery during the Endoscopic Resection of Subepithelial Tumors of the Upper Gastrointestinal Tract10.3390/diagnostics111121602075-4418https://doaj.org/article/9e3721114e334693af76aac94c85c2222021-11-01T00:00:00Zhttps://www.mdpi.com/2075-4418/11/11/2160https://doaj.org/toc/2075-4418Background: 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.Shun-Wen HsiaoMei-Wen ChenChia-Wei YangKuo-Hua LinYang-Yuan ChenChew-Teng KorSiou-Ping HuangHsu-Heng YenMDPI AGarticlesubepithelial tumorendoscopic resectionlaparoscopyGISTMedicine (General)R5-920ENDiagnostics, Vol 11, Iss 2160, p 2160 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	subepithelial tumor endoscopic resection laparoscopy GIST Medicine (General) R5-920
spellingShingle	subepithelial tumor endoscopic resection laparoscopy GIST Medicine (General) R5-920 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
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.
format	article
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
title	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_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_sort	nomogram for predicting laparoscopic and endoscopic cooperative surgery during the endoscopic resection of subepithelial tumors of the upper gastrointestinal tract
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/9e3721114e334693af76aac94c85c222
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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

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