Prediction of technically difficult endoscopic submucosal dissection for large superficial colorectal tumors: a novel clinical score model.

Gastrointestinal Endoscopy
Bing LiYun-Shi Zhong

Abstract

Endoscopic submucosal dissection (ESD) is a promising technique for removing superficial GI tumors, but ESD is technically difficult. The aim of this study was to establish a clinical score model for grading technically difficult colorectal ESD. Data on patients, lesions, and outcomes of colorectal ESD at 2 centers were analyzed. The objective parameter of successful ESD within 60 minutes was set as an endpoint to evaluate the difficulty. Independent predictors of difficulty in the derivation cohort were identified by multiple logistic regression analysis and used to develop a clinical score. We validated the score model in the validation cohort. The clinical score comprised tumor size of 30 to 50 mm (1 point) or ≥50 mm (2 points), at least two-thirds circumference of the lesion (2 points), location in the cecum (1 point), flexure (2 points) or dentate line (1 point), and laterally spreading tumor nongranular lesions (1 point). Areas under the receiver operator characteristic curves for the score model were comparable (derivation [.70] vs internal validation [.69] vs external validation [.69]). The probability of successful ESD within 60 minutes in easy (score = 0), intermediate (score = 1), difficult (score = 2-3), and very di...Continue Reading

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Citations

May 18, 2021·Gastrointestinal Endoscopy·Jérémie JacquesUNKNOWN French colorectal ESD group
May 18, 2021·Gastrointestinal Endoscopy·Bing LiPing-Hong Zhou
Jun 22, 2021·Gastrointestinal Endoscopy·Naohisa Yahagi, Tadateru Maehata
Aug 10, 2021·Journal of Gastroenterology and Hepatology·Wei SuPinghong Zhou

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