1Unit of Gastroenterology and Digestive Endoscopy, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
2Unit of Digestive Endoscopy, Vita Salute San Raffaele University, Milan, Italy
Copyright © 2022 Korean Society of Gastrointestinal Endoscopy
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Conflicts of Interest
The authors have no potential conflicts of interest.
Funding
None.
Author Contributions
Conceptualization: PC, FA; Data curation: ML, MC, FB, AC; Formal analysis: PC, ML; Investigation: PC, FA; Methodology: PC, ML; Supervision: PC, RS; Validation: PC, RS; Visualization: PC; Writing–original draft: PC; Writing–review & editing: all authors.
Values are presented as mean±standard deviation or number (%).
ESD, endoscopic submucosal dissection; WESD, waterjet-assisted ESD; CESD, conventional ESD; ASA, American Society of Anesthesiologists; LST-G, laterally spreading tumors granular type; LST-NG, laterally spreading tumors non‐granular type.
Odds ratio (95% confidence interval) | p-value | |
---|---|---|
Univariate logistic regression analysis | ||
Macroscopic typea) | ||
> LST-G | 1.042 (0.20–5.51) | 0.962 |
> LST-NG | 0.714 (0.14–3.69) | 0.688 |
Locationb) | ||
> Right side | 0.305 (0.09–1.07) | 0.064 |
> Left side | 0.606 (0.13–2.85) | 0.526 |
Tumor size (<40 vs. >40 mm) | 0.934 (0.32–2.75) | 0.901 |
Fibrosis (F=0 vs. F>0) | 0.254 (0.05–1.16) | 0.043 |
WESD | 3.083 (1.05–9.02) | 0.039 |
Multivariate logistic regression analysis | ||
Fibrosis (F=0 vs. F>0) | 0.239 (0.05–1.21) | 0.084 |
WESD | 3.270 (1.01–10.69) | 0.049 |
Characteristic | Total (n=174) | WESD (n=123) | CESD (n=51) | p-value |
---|---|---|---|---|
Age (yr) | 69.5±10.5 | 70.1±10.4 | 68.2±10.5 | 0.281 |
Sex, male | 99 (56.9) | 65 (52.8) | 34 (66.7) | 0.094 |
ASA score | 0.091 | |||
1, 2 | 157 | 112 | 43 | |
3 | 17 | 9 | 8 | |
Tumors site | 0.032 | |||
Right colon | 55 (31.6) | 32 (26.0) | 23 (45.1) | |
Left colon | 38 (21.8) | 27 (22.0) | 11 (21.6) | |
Rectum | 81 (46.6) | 64 (52.0) | 17 (33.3) | |
Macroscopic type | 0.175 | |||
LST-G | 81 (46.6) | 62 (50.4) | 19 (37.3) | |
LST-NG | 67 (38.5) | 42 (34.1) | 25 (49.0) | |
Sessile | 26 (14.9) | 19 (15.4) | 7 (13.7) | |
Size (mm) | 35±17.5 | 37.7±18.8 | 28.3±11.4 | 0.001 |
Specimen area (cm2) | 8.6±10.9 | 10.0±12.5 | 5.2±3.8 | 0.008 |
Fibrosis | 0.810 | |||
F0 | 62 (35.6) | 45 (36.6) | 17 (33.3) | |
F1 | 92 (52.9) | 65 (52.8) | 27 (52.9) | |
F2 | 20 (11.5) | 13 (10.6) | 7 (13.7) | |
Pathological diagnosis | 0.090 | |||
Low-grade dysplasia | 10 (5.7) | 4 (3.3) | 6 (11.8) | |
High-grade dysplasia | 116 (66.7) | 84 (68.3) | 32 (62.7) | |
T1 | 47 (27.0) | 35 (28.5) | 12 (23.5) | |
Hyperplastic | 1 (0.6) | 0 (0) | 1 (2.0) |
Outcomes | Total (n=174) | WESD (n=123) | CESD (n=51) | p-value |
---|---|---|---|---|
En-bloc resection | 159 (91.4) | 116 (94.3) | 43 (84.3) | 0.032 |
Complete resection | 148 (85.1) | 107 (87.0) | 41 (80.4) | 0.266 |
Curative resection | 125 (71.8) | 90 (73.2) | 35 (68.6) | 0.544 |
Switch to hybrid ESD | 37 (21.3) | 17 (13.8) | 20 (39.2) | <0.001 |
Procedure speed (mm2/min) | 13.7±9.2 | 13.4±8.7 | 14.7±10.9 | 0.492 |
Adverse events | 12 (6.9) | 7 (5.7) | 5 (9.8) | 0.329 |
Perforation | 6 (3.4) | 3 (2.4) | 3 (5.9) | |
Bleeding | 4 (2.3) | 2 (1.6) | 2 (3.9) | |
Post-polypectomy syndrome | 0 | 0 | 0 | |
Others | 2 (1.1) | 2 (1.6) | 0 | |
Need for surgery | 37 (21.3) | 28 (22.8) | 9 (17.6) | 0.452 |
Adverse event | 0 | 0 | 0 | |
Histopathology | 37 | 28 | 9 | |
Follow-up available | 111 (63.8) | 83 (67.5) | 28 (54.9) | 0.116 |
Follow-up (mo) | 15.6±12.5 | 16.6±12.9 | 13.7±12.1 | 0.171 |
Recurrence | 1 (0.6) | 1 (0.8) | 0 (0) | 1 |
Length of hospital stay (day) | 1.8±1.1 | 2±1.2 | 1.3±0.8 | <0.001 |
Odds ratio (95% confidence interval) | p-value | |
---|---|---|
Univariate logistic regression analysis | ||
Macroscopic type |
||
> LST-G | 1.042 (0.20–5.51) | 0.962 |
> LST-NG | 0.714 (0.14–3.69) | 0.688 |
Location |
||
> Right side | 0.305 (0.09–1.07) | 0.064 |
> Left side | 0.606 (0.13–2.85) | 0.526 |
Tumor size (<40 vs. >40 mm) | 0.934 (0.32–2.75) | 0.901 |
Fibrosis (F=0 vs. F>0) | 0.254 (0.05–1.16) | 0.043 |
WESD | 3.083 (1.05–9.02) | 0.039 |
Multivariate logistic regression analysis | ||
Fibrosis (F=0 vs. F>0) | 0.239 (0.05–1.21) | 0.084 |
WESD | 3.270 (1.01–10.69) | 0.049 |
Values are presented as mean±standard deviation or number (%). ESD, endoscopic submucosal dissection; WESD, waterjet-assisted ESD; CESD, conventional ESD; ASA, American Society of Anesthesiologists; LST-G, laterally spreading tumors granular type; LST-NG, laterally spreading tumors non‐granular type.
Values are presented as number (%) or mean±standard deviation. ESD, endoscopic submucosal dissection; WESD, waterjet-assisted ESD; CESD, conventional ESD.
LST-G, laterally spreading tumors granular type; LST-NG, laterally spreading tumors non‐granular type; WESD, waterjet-assisted endoscopic submucosal dissection. Sessile type as reference. rectal location as reference.