Published online Jan 27, 2023. doi: 10.4240/wjgs.v15.i1.94
Peer-review started: November 14, 2022
First decision: December 1, 2022
Revised: December 6, 2022
Accepted: December 23, 2022
Article in press: December 23, 2022
Published online: January 27, 2023
Endoscopic submucosal dissection (ESD) has become a new development trend in the treatment of early gastric cancer due to its special minimally invasive advantages. Although it is minimally invasive surgery, it also has some risks such as bleeding and perforation.
The time of ESD operation is closely related to bleeding and perforation.
This study aims to investigate the operation time of endoscopic subspecific section and the influencing factors of delayed bleeding after operation.
The baseline data, clinical features, and endoscopic and pathological characteristics of patients were collected. The multivariate linear regression model was used to investigate the influencing factors of ESD operation time. Logistic regression analysis was carried out to evaluate the influencing factors of postoperative delayed hemorrhage.
The maximum diameter of the lesion, lesion morphology, and ESD operation time were independent influencing factors for delayed hemorrhage after ESD. Patients with lesion ≥ 3.0 cm (OR = 3.785, 95%CI: 1.165-4.277), lesion morphology-concave (OR = 10.985, 95%CI: 2.133-35.381), and ESD operation time ≥ 60 min (OR = 2.958, 95%CI: 1.117-3.526) were prone to delayed hemorrhage after ESD.
The risk of delayed bleeding after ESD is higher when the maximum diameter of the lesion is ≥ 3.0 cm, the lesion morphology is concave, and the ESD operation time is longer.
Further research should be made on other factors related to delayed bleeding after ESD operation, such as factors during operation and individual related factors. Strict control of surgical indications and adherence to individualized treatment can help reduce the occurrence of complications.