Advancements in endoscopic closure: Embracing a new era of managing complications and postprocedural defects after endoscopic submucosal dissection

Table 3 Complication rates and risk factors in gastric endoscopic submucosal dissection

Ref.	Country of origin	Intraoperative perforation	Delayed bleeding	Stricture risk
Hatta et al[38]	Japan	-	4.7%-5.0%	-
			RFs: Chronic kidney disease with hemodialysis, antithrombotic agents (aspirin, P2Y12RA, cilostazol, warfin, DOAC), multiple tumors, tumor size > 30 mm, tumor location in lower third
Suzuki et al[87]	Japan	2.3%	4.4%	-
Zullo et al[86]	Western countries	3.1%	5.8%	-
Yano et al[32]	Japan	-	8.5% (7.3% in the first 5 days)	-
			RFs in first 5 days: Tumor location in the distal stomach, expanded indications or non-indicated lesions, a specimen diameter of ≥ 40 mm, and antithrombotic therapy
			Risk factors after 5 days: Tumor location in the proximal stomach, hemodialysis, and antithrombotic therapy
Okada et al[37]	Japan	-	4.81%	-
			RFs in first 4 days: Size of the specimen, tumor location in the lower third of the stomach
			Risk factors after 4 days: Size of the specimen, tumor location in the middle third of the stomach, hypertension, high body mass index (≥ 25 kg/m2)
Miyahara et al[29]	Japan	3.7%	6.9%	-
		RFs: Tumor location, massive submucusal invasion, endoscopists’ experience of 100-149 cases and hypertension	RFs: Tumor location, tumor size, and scarred lesion
Toyokawa et al[30]	Japan	2.4%	5.0%	-
		RFs: Location in the upper area of the stomach	Risk factors: Age ≥ 80 years, long procedure time
Nam et al[31]	South Korea	-	4.1%	-
			RFs in the first 24 hours: Age ≤ 65 years, resection size ≥ 30 mm, procedure time ≥ 20 minutes, lower third of the stomach, erosion, clopidogrel use
			RFs after 24 hours: The middle to upper third of the stomach, undifferentiated carcinoma, erosion, high risk of stigma during second-look endoscopy, history of early PEB, clopidogrel use
Sumiyoshi et al[155]	Japan	-	-	Cardia: 21.3%
				Antrum: 3.2%
				RFs: More than 75% of the circumferential extent (both locations)
Coda et al[156]	Japan	-	-	Cardia: 17%
				Pyloric: 7%
				RF: Circumferential extent > 75%, longitudinal extent > 5 cm

RFs: Risk factors; P2Y12RA: Receptor antagonist; DOAC: Direct oral anticoagulants; PEB: Post-endoscopic submucosal dissection bleeding.