Year 2018 / Volume 110 / Number 11
Submission and tracking of manuscripts
Instructions to authors

Submission and tracking

SED 2019

SED 2019

Spanish Week of Digestive Diseases 2019

More Information

REED Journal

REED Journal

Play video

Year 2018 / Volume 110 / Number 11

Original

Switching from endoscopic submucosal dissection to salvage piecemeal knife-assisted snare resection to remove a lesion: A preoperative risk score from the beginning.

699-705

José C. Marín-Gabriel, David Lora Pablos, José Díaz-Tasende, Pilar Cancelas-Navia, Sarbelio Rodríguez Muñoz, Andrés J. del Pozo-García, Marina Alonso-Riaño, Yolanda Rodríguez-Gil, Carolina Ibarrola-Andrés, Gregorio Castellano Tortajada,

Background and aims: endoscopic submucosal dissection (ESD) in the Western setting remains a challenge. Therefore, other simplified techniques such as knife-assisted snare resection (KAR) have been reported to overcome this issue. Methods: patients who underwent an ESD for the treatment of gastrointestinal neoplasms were included in a retrospective cross-sectional observational study. Factors associated with the end of ESD as a salvage p-KAR were identified and a logistic regression model was developed. Results: a total of 136 lesions in 133 patients were analyzed. Operator experience of under 50 cases and the combination of lesion size > 30 mm and colorectal location were independent predictive factors for switching to a salvage p-KAR according to the multivariate logistic regression analysis. We developed a risk scoring system based on these four variables (experience, size, location and the combination of size and location) with a receiver operating characteristic curve of 0.81 (95% CI: 0.74-0.89). The diagnostic accuracy of the score for a cut-off point ≥ 5 had a sensitivity of 0.79 (95% CI: 0.66-0.93) and a specificity of 0.71 (95% CI: 0.61-0.80). Conclusion: a simple predictive score system that includes four preoperative factors accurately predicts ESD to finish as a p-KAR. A careful selection of cases considering these variables could be useful to achieve better outcomes in the Western setting.

Valoración del lector: Valora este artículo:
Share Button
Send by e-mail

New comment


Security code:
CAPTCHA code image
Speak the codeChange the code
 

Comments

No hay comentarios para este artículo.
Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
© 2019 The Spanish Journal of Gastroenterology