Clinical Study

Risk Factors for Additional Surgery after Iatrogenic Perforations due to Endoscopic Submucosal Dissection

Table 1

Basic characteristics of the 69 patients with perforation.

Total ()Nonsurgery group ()Surgery group () value

Age, median (range) (years)63 (48–85)64 (48–85)62 (50–76)0.695
Male sex, n (%)44 (63.8)38 (63.3)6 (66.7)1.000
Location (vertical), n (%)0.888
 Upper third16 (23.2)14 (23.3)2 (22.2)
 Middle third38 (55.1)32 (53.3)6 (66.7)
 Lower third15 (21.7)14 (23.3)1 (11.1)
Location (circumferential), n (%)0.000
 Anterior wall14 (18.8)7 (11.7)7 (77.8)
 Posterior wall18 (26.1)18 (30.0)0 (0.0)
 Lesser curvature24 (34.8)24 (40.0)0 (0.0)
 Greater curvature13 (18.8)11 (18.3)2 (22.2)
Resected size, median (range) (cm)4.0 (0.7–14.0)4.0 (1.2–10.0)4.0 (0.7–14.0)0.748
Histologic type, n (%)0.008
 Adenoma36 (52.2)34 (56.7)2 (22.2)
 Early gastric cancer20 (29.0)18 (30.0)2 (22.2)
 Gastrointestinal stromal tumor7 (10.2)5 (8.3)2 (22.2)
 Leiomyoma1 (1.4)1 (1.7)0 (0.0)
 Schwannoma2 (2.9)0 (0.0)2 (22.2)
 No residual tumor3 (4.3)2 (3.3)1 (11.1)
Endoscopic procedure, n (%)0.594
 EMR9 (13.0)9 (15.0)0 (0.0)
 ESD60 (87.0)51 (85.0)9 (100)
Procedure time, median (range) (min)39 (6–215)38 (6–215)39 (8–109)0.803
En bloc resection, n (%)62 (89.9)53 (88.3)9 (100)0.582
Complete resection, n (%)53 (76.8)48 (80.0)5 (55.6)0.197
Perforation, n (%)0.147
 Macroperforation45 (65.2)37 (61.7)8 (88.9)
 Microperforation24 (34.8)23 (38.3)1 (11.1)
Endoclip use, n (%)55 (79.7)46 (76.7)9 (100)0.187
Percutaneous needle aspiration, n (%)9 (13.0)7 (11.7)2 (22.2)0.333
Size of the free air in the abdominal cavity,
median (range) (cm)
2.6 (0.0–7.9)2.5 (0.0–7.9)4.1 (0.0–7.3)0.838
Abdominal pain score (NRS), median (range)4 (0–10)2.0 (0–10)6 (4–7)0.002
Postprocedure pain killer use, median (range)1 (0–7)0 (0–5)3 (1–7)0.000
WBC count, median (range) (mm3)10,820 (6,190–21,540)10,655 (6,190–19,140)10,870 (9,450–21,540)0.318
Body temperature, median (range) (°C)36.3 (36.0–38.2)36.3 (36.0–38.2)36.7 (36.0–38.2)0.149
Heart rate/min, median (range)78 (56–112)76 (56–112)84 (68–110)0.033

EMR: endoscopic mucosal resection; ESD: endoscopic submucosal dissection.