A Nomogram for Predicting Laparoscopic and Endoscopic Cooperative Surgery during the Endoscopic Resection of Subepithelial Tumors of the Upper Gastrointestinal Tract
Abstract
:1. Introduction
2. Materials & Methods
2.1. Inclusion Criteria and Exclusion Criteria of the Study Population
2.2. Equipment and Procedure
2.3. Ethical Considerations
2.4. Statistical Analysis
3. Results
3.1. Clinical Features of the Study Population
3.2. Analysis of Complication and Risk Factor Predictive for LECS
3.3. Development and Validation of the Nomogram
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristics | Number | |
---|---|---|
Median age, years (Median, IQR) | 55 (48–60.75) | |
Sex, n (%) | ||
Male | 61 (49.6%) | |
Female | 62 (50.4%) | |
Hospital day, days (Median, IQR) | 6 (5–8) | |
Procedure time, minutes (Median, IQR) | 60 (30–90) | |
Tumor location | ||
Esophagus | 30 | |
Gastric fundus | 21 | |
Gastric cardia | 21 | |
Gastric body | 35 | |
Gastric antrum | 14 | |
Duodenum | 2 | |
Tumor size, cm (Median, IQR) | 1.5 (1–2.5) | |
Layer of tumor origin, n (%) | ||
Submucosa | 38 (30.9%) | |
Muscularis propria | 85 (69.1%) | |
Complications, n (%) | ||
Perforation | 47 (38.2%) | |
Perforation with laparoscopic cooperative surgery | 30 (24.4%) | |
Delayed perforation | 1 (0.8%) | |
Delayed bleeding | 1 (0.8%) | |
Pathology report, n (%) | ||
Leiomyoma | 56 (45.5%) | |
GIST | 42 (34.1%) | |
Aberrant pancreas | 8 (6.5%) | |
Neuroendocrine tumor | 3 (2.4%) | |
Others * | 14 (11.4%) | |
En bloc resection rate | 114 (92.7%) | |
Follow-up days, day (Median, IQR) | 242 (69–774) |
Esophagus | Gastric Fundus | Gastric Cardia | Gastric Body | Gastric Antrum | DuodenuSm | |
---|---|---|---|---|---|---|
GIST | 1 | 17 | 7 | 14 | 3 | 0 |
Leiomyoma | 25 | 2 | 13 | 16 | 0 | 0 |
Aberrant pancreas | 0 | 0 | 0 | 1 | 6 | 1 |
Neuroendocrine tumor | 0 | 0 | 0 | 2 | 0 | 1 |
Others | 4 | 2 | 1 | 2 | 5 | 0 |
Without LECS | With LECS | p-Value | |
---|---|---|---|
Sex (M/F) | 47/46 | 14/16 | 0.7134 |
Age, year (mean, SD) | 51.79 (13.09) | 58.16 (11.06) | 0.0018 |
Size, cm (mean, SD) | 1.61 (0.89) | 2.20 (1.10) | 0.0003 |
Site (E/Antrum/Body/Cardia/Fundus/D) | 30/13/26/17/5/2 | 0/1/9/4/16/0 | <0.0001 |
Pathology (GIST/Leiomyoma/Others) | 22/49/22 | 20/7/3 | 0.0001 |
Resection method (ESD/STER) | 78/15 | 29/1 | 0.0712 |
Univariable Analysis | Multivariable Analysis | |||||
---|---|---|---|---|---|---|
cOR (95% CI) | p-value | AUC | Coef. | adj. OR (95% CI) | p-value | |
Site | 0.820 | |||||
Others | 1 | 1 | ||||
Gastric body | 3.57 (0.68, 18.65) | 0.132 | 1.60 | 4.95 (0.78, 31.62) | 0.091 | |
Gastric fundus | 100.8 (6.36, 1598.31) | 0.001 | 4.25 | 70.32 (3.74, 1320.99) | 0.005 | |
Size (per 1 unit increase) | 1.84 (0.94, 3.60) | 0.076 | 0.658 | 0.53 | 1.70 (0.68, 4.27) | 0.257 |
Age ≥ 55 | 3.91 (0.82, 18.56) | 0.086 | 0.653 | 1.49 | 4.45 (0.61, 32.22) | 0.140 |
Female | 1.14 (0.31, 4.17) | 0.845 | 0.517 | −0.22 | 0.80 (0.15, 4.35) | 0.800 |
Training Data | Validation Data | Test Data | p-Value | |
---|---|---|---|---|
Sample size | 54 | 28 | 41 | |
Age, years | 54.89 ± 10.55 | 50.07 ± 12.57 | 53.56 ± 15.51 | 0.275 |
<55 | 23 (42.59%) | 16 (57.14%) | 20 (48.78%) | 0.454 |
≥55 | 31 (57.41%) | 12 (42.86%) | 21 (51.22%) | |
Sex | ||||
Female | 28 (51.85%) | 15 (53.57%) | 19 (46.34%) | 0.807 |
Male | 26 (48.15%) | 13 (46.43%) | 22 (53.66%) | |
Site | ||||
Gastric fundus | 5 (9.26%) | 3 (10.71%) | 13 (31.71%) | 0.041 |
Gastric body | 18 (33.33%) | 7 (25%) | 10 (24.39%) | |
Others | 31 (57.41%) | 18 (64.29%) | 18 (43.9%) | |
Size, cm | 1.87 ± 1.04 | 1.67 ± 0.94 | 1.66 ± 0.92 | 0.516 |
<1 | 10 (18.52%) | 6 (21.43%) | 10 (24.39%) | 0.811 |
≥1 to <2 | 23 (42.59%) | 14 (50%) | 18 (43.9%) | |
≥2 to <3 | 10 (18.52%) | 5 (17.86%) | 9 (21.95%) | |
3 | 11 (20.37%) | 3 (10.71%) | 4 (9.76%) | |
LCES | ||||
No | 43 (79.63%) | 21 (75%) | 29 (70.73%) | 0.604 |
Yes | 11 (20.37%) | 7 (25%) | 12(29.27%) |
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Hsiao, S.-W.; Chen, M.-W.; Yang, C.-W.; Lin, K.-H.; Chen, Y.-Y.; Kor, C.-T.; Huang, S.-P.; Yen, H.-H. A Nomogram for Predicting Laparoscopic and Endoscopic Cooperative Surgery during the Endoscopic Resection of Subepithelial Tumors of the Upper Gastrointestinal Tract. Diagnostics 2021, 11, 2160. https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11112160
Hsiao S-W, Chen M-W, Yang C-W, Lin K-H, Chen Y-Y, Kor C-T, Huang S-P, Yen H-H. A Nomogram for Predicting Laparoscopic and Endoscopic Cooperative Surgery during the Endoscopic Resection of Subepithelial Tumors of the Upper Gastrointestinal Tract. Diagnostics. 2021; 11(11):2160. https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11112160
Chicago/Turabian StyleHsiao, Shun-Wen, Mei-Wen Chen, Chia-Wei Yang, Kuo-Hua Lin, Yang-Yuan Chen, Chew-Teng Kor, Siou-Ping Huang, and Hsu-Heng Yen. 2021. "A Nomogram for Predicting Laparoscopic and Endoscopic Cooperative Surgery during the Endoscopic Resection of Subepithelial Tumors of the Upper Gastrointestinal Tract" Diagnostics 11, no. 11: 2160. https://0-doi-org.brum.beds.ac.uk/10.3390/diagnostics11112160