Management and associated factors of delayed perforation after gastric endoscopic submucosal dissection

Table 4 Factors associated with delayed perforation induced by gastric endoscopic submucosal dissection n (%)

Clinicopathological finding	Univariate analysis			Multivariate analysis, OR (95%CI), P value
	ESD cases without perforation (n = 4813)	ESD cases with delayed perforation (n = 7)	P value
Age (yr)			1.00	-
< 70	2538 (99.8)	4 (0.2)
≥ 70	2275 (99.9)	3 (0.1)
Sex			0.16	-
Male	3828 (99.9)	4 (0.1)
Female	985 (99.7)	3 (0.3)
Chronological periods			1.00	-
1st period: 1999-2005	2194 (99.9)	3 (0.1)
2nd period: 2006-2012	2619 (99.8)	4 (0.2)
Clinical indications			0.02	NS
Outside indications	169 (98.8)	2 (1.2)
Other indications1	4644 (99.9)	5 (0.1)
Stomach status			0.006	11.0 (1.7-73.3), 0.013
Normal stomach/Remnant stomach	4732 (99.9)	5 (0.1)
Gastric tube	81 (97.6)	2 (2.4)
Location			0.047	NS
Upper/Middle	2894 (99.8)	7 (0.2)
Lower	1919 (100)	0 (0.0)
Circumference			0.09	-
Greater curvature	774 (99.6)	3 (0.4)
Others2	4039 (99.9)	4 (0.1)
Size (mm)			0.43	-
≤ 20	3395 (99.9)	4 (0.1)
> 20	1418 (99.8)	3 (0.2)
Depth of invasion			0.34	-
M	3988 (99.9)	5 (0.1)
SM	825 (99.8)	2 (0.2)
Ulceration			0.34	-
Absent	3982 (99.9)	5 (0.1)
Present	831 (99.8)	2 (0.2)
Histological type			0.09	-
Differentiated	4466 (99.9)	5 (0.1)
Undifferentiated	347 (99.4)	2 (0.6)
Type of resection			1.00	-
En bloc resection	4743 (99.9)	7 (0.1)
Piecemeal resection	70 (100)	0 (0.0)
Procedure time (h)			0.046	NS
< 2	3758 (99.9)	3 (0.1)
≥ 2	1055 (99.6)	4 (0.4)

¹Other indications, absolute indications, expanded indications and locally recurrent early gastric cancer;

²Others, lesser curvature, anterior wall and posterior wall. ESD: Endoscopic submucosal dissection; M: Mucosa; SM: Submucosa; NS: Not significant.