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Risk factors for perforation of gastric endoscopic submucosal dissection

a systematic review and meta-analysis

Ding, Xiang; Luo, Hesheng; Duan, Houyu

European Journal of Gastroenterology & Hepatology: December 2019 - Volume 31 - Issue 12 - p 1481–1488
doi: 10.1097/MEG.0000000000001543
Review Article
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The aim of this systematic review and meta-analysis was to identify significant risk factors for perforation in gastric endoscopic submucosal dissection. Studies published in the English language were searched for in Embase, WEB OF SCIENCE, Medline (PubMed and Ovid) and the Cochrane Central Register of Controlled Trials and Database of Systematic Reviews. Inclusion criteria and exclusion criteria were defined in advance in this work. Probable risk factors in a total of eighteen studies were evaluated, and the results are represented in the case of dichotomous variables as an odds ratio (with 95% confidence interval). Analysing the risk factors, the odds ratios were 1.98 (95% confidence interval: 1.02–3.85) for liver disease; 3.62 (95% confidence interval: 2.83–4.65) for vertical localization (the upper portion of the stomach); 1.42 (95% confidence interval: 1.03–1.96) for resected size (>20 mm); 3.05 (95% confidence interval: 1.80–5.17) for depth of invasion (submucosal); 4.12 (95% confidence interval: 1.63–10.39) for operation time (>2 hours); 1.59 (95% confidence interval: 1.25–2.01) for gross type of lesion (depressed or flat); and 3.88 (95% confidence interval: 2.69–5.60) for piecemeal resection. Liver disease, vertical localization (the upper portion of the stomach), resected size (>20 mm), depth of invasion (submucosal), operation time (>2 hours), gross type of lesion (flat or depressed), and piecemeal resection were verified to be risk factors for perforation of gastric endoscopic submucosal dissection.

Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China

Received 21 April 2019 Accepted 21 July 2019

Correspondence to Hesheng Luo, Department of Gastroenterology, Renmin Hospital of Wuhan University, Zhangzhidong Road, Wuhan 430060, China, Tel: +(86)18908644197; fax: 027 88042292; e-mail: xhnk@163.com

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