Antral or pyloric deformity is a risk factor for the development of postendoscopic submucosal dissection pyloric strictures

Kyu Yeon Hahn, Jun Chul Park, Hyun Jik Lee, Chan Hyuk Park, Hyunsoo Chung, Sung Kwan Shin, Sang Kil Lee, Yong Chan Lee

Research output: Contribution to journalArticle

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Abstract

Background/Aims: Surgeons must be aware of risk factors for strictures before performing endoscopic submucosal dissection (ESD), to enable early interventions to prevent severe strictures. Methods: This study was a single-center retrospective study. We reviewed the clinical data of patients who has undergone gastric ESD from January 2007 to December 2012. Results: Among the 3,819 patients who had undergone gastric ESD, 11 patients (7.2%) developed pyloric strictures and received successful endoscopic balloon dilation. Significant differences were noted between the patients without and with post-ESD strictures for pretreatment of antral or pyloric deformities (46.4% vs 81.8%), the proportion of extension to the lumen circumference (>3/4, 9.4% vs 54.5%), the longitudinal extent of mucosal defects (27.9±10.1 mm vs 51.5±10.8 mm), and post-ESD bleeding (2.9% vs 27.3%). Multivariate analysis revealed that pretreatment antral or pyloric deformities (odds ratio [OR], 30.53; 95% confidence interval [CI], 1.476 to 631.565; p=0.027), larger longitudinal extent of mucosal defects (OR, 1.20; 95% CI, 1.074 to 1.340; p=0.001), and circumferential extension of ≥3/4 (OR, 13.69; 95% CI, 1.583 to 118.387; p=0.017) were independent risk factors for post-ESD stricture. Conclusions: Antral or pyloric deformities, sub-circumferential resection over more than 75% of the circumference and greater longitudinal extent of mucosal defects are independent risk factors for post-ESD stricture.

Original languageEnglish
Pages (from-to)757-763
Number of pages7
JournalGut and liver
Volume10
Issue number5
DOIs
Publication statusPublished - 2016 Sep

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Dissection
Pathologic Constriction
Odds Ratio
Confidence Intervals
Stomach
Endoscopic Mucosal Resection
Antral
Dilatation
Multivariate Analysis
Retrospective Studies
Hemorrhage

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

Cite this

Hahn, Kyu Yeon ; Park, Jun Chul ; Lee, Hyun Jik ; Park, Chan Hyuk ; Chung, Hyunsoo ; Shin, Sung Kwan ; Lee, Sang Kil ; Lee, Yong Chan. / Antral or pyloric deformity is a risk factor for the development of postendoscopic submucosal dissection pyloric strictures. In: Gut and liver. 2016 ; Vol. 10, No. 5. pp. 757-763.
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title = "Antral or pyloric deformity is a risk factor for the development of postendoscopic submucosal dissection pyloric strictures",
abstract = "Background/Aims: Surgeons must be aware of risk factors for strictures before performing endoscopic submucosal dissection (ESD), to enable early interventions to prevent severe strictures. Methods: This study was a single-center retrospective study. We reviewed the clinical data of patients who has undergone gastric ESD from January 2007 to December 2012. Results: Among the 3,819 patients who had undergone gastric ESD, 11 patients (7.2{\%}) developed pyloric strictures and received successful endoscopic balloon dilation. Significant differences were noted between the patients without and with post-ESD strictures for pretreatment of antral or pyloric deformities (46.4{\%} vs 81.8{\%}), the proportion of extension to the lumen circumference (>3/4, 9.4{\%} vs 54.5{\%}), the longitudinal extent of mucosal defects (27.9±10.1 mm vs 51.5±10.8 mm), and post-ESD bleeding (2.9{\%} vs 27.3{\%}). Multivariate analysis revealed that pretreatment antral or pyloric deformities (odds ratio [OR], 30.53; 95{\%} confidence interval [CI], 1.476 to 631.565; p=0.027), larger longitudinal extent of mucosal defects (OR, 1.20; 95{\%} CI, 1.074 to 1.340; p=0.001), and circumferential extension of ≥3/4 (OR, 13.69; 95{\%} CI, 1.583 to 118.387; p=0.017) were independent risk factors for post-ESD stricture. Conclusions: Antral or pyloric deformities, sub-circumferential resection over more than 75{\%} of the circumference and greater longitudinal extent of mucosal defects are independent risk factors for post-ESD stricture.",
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Antral or pyloric deformity is a risk factor for the development of postendoscopic submucosal dissection pyloric strictures. / Hahn, Kyu Yeon; Park, Jun Chul; Lee, Hyun Jik; Park, Chan Hyuk; Chung, Hyunsoo; Shin, Sung Kwan; Lee, Sang Kil; Lee, Yong Chan.

In: Gut and liver, Vol. 10, No. 5, 09.2016, p. 757-763.

Research output: Contribution to journalArticle

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AU - Hahn, Kyu Yeon

AU - Park, Jun Chul

AU - Lee, Hyun Jik

AU - Park, Chan Hyuk

AU - Chung, Hyunsoo

AU - Shin, Sung Kwan

AU - Lee, Sang Kil

AU - Lee, Yong Chan

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AB - Background/Aims: Surgeons must be aware of risk factors for strictures before performing endoscopic submucosal dissection (ESD), to enable early interventions to prevent severe strictures. Methods: This study was a single-center retrospective study. We reviewed the clinical data of patients who has undergone gastric ESD from January 2007 to December 2012. Results: Among the 3,819 patients who had undergone gastric ESD, 11 patients (7.2%) developed pyloric strictures and received successful endoscopic balloon dilation. Significant differences were noted between the patients without and with post-ESD strictures for pretreatment of antral or pyloric deformities (46.4% vs 81.8%), the proportion of extension to the lumen circumference (>3/4, 9.4% vs 54.5%), the longitudinal extent of mucosal defects (27.9±10.1 mm vs 51.5±10.8 mm), and post-ESD bleeding (2.9% vs 27.3%). Multivariate analysis revealed that pretreatment antral or pyloric deformities (odds ratio [OR], 30.53; 95% confidence interval [CI], 1.476 to 631.565; p=0.027), larger longitudinal extent of mucosal defects (OR, 1.20; 95% CI, 1.074 to 1.340; p=0.001), and circumferential extension of ≥3/4 (OR, 13.69; 95% CI, 1.583 to 118.387; p=0.017) were independent risk factors for post-ESD stricture. Conclusions: Antral or pyloric deformities, sub-circumferential resection over more than 75% of the circumference and greater longitudinal extent of mucosal defects are independent risk factors for post-ESD stricture.

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