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- Title
Predictors of severe submucosal fibrosis during endoscopic submucosal dissection in patients with ulcerative colitis: Retrospective cohort study.
- Authors
Nishio, Masafumi; Hirasawa, Kingo; Saigusa, Yusuke; Atsusaka, Reo; Azuma, Daisuke; Ozeki, Yuichiro; Sawada, Atsushi; Ikeda, Ryosuke; Fukuchi, Takehide; Kobayashi, Ryosuke; Sato, Chiko; Ogashiwa, Tsuyoshi; Inayama, Yoshiaki; Kunisaki, Reiko; Maeda, Shin
- Abstract
Objectives: Severe submucosal fibrosis is a crucial technical difficulty encountered during endoscopic submucosal dissection (ESD) in patients with ulcerative colitis (UC). We aimed to identify predictors of severe submucosal fibrosis in patients with UC. Methods: We retrospectively included 55 tumors resected using ESD from 48 consecutive patients with UC. We analyzed the clinicopathological characteristics and treatment outcomes between the F0/1 (none to mild submucosal fibrosis) group (n = 28) and F2 (severe submucosal fibrosis) group (n = 27). Results: No significant difference was found between the F0/1 and F2 groups in en bloc resection rate (100% vs. 96%, P = 0.49), the R0 resection rate (100% vs. 93%, P = 0.24), and the dissection speed (0.18 vs. 0.13 cm2/min, P = 0.07). Intraoperative perforation was more common in the F2 group (30%) than in the F0/1 group (8%; P = 0.01). Multivariable analysis showed that a longer duration of UC (≥10 years; odds ratio [OR] 6.11; 95% confidence interval [CI] 1.20–31.03; P = 0.03) and scarring of background mucosa of the tumor (OR 39.61; 95% CI 3.91–400.78; P < 0.01) were independent predictors of severe submucosal fibrosis. Conclusion: Long UC duration and scarring background mucosa were predictors of severe submucosal fibrosis associated with perforation during ESD.
- Subjects
ULCERATIVE colitis; FIBROSIS; COHORT analysis; INFLAMMATORY bowel diseases; DISSECTION; RETROSPECTIVE studies
- Publication
Digestive Endoscopy, 2024, Vol 36, Issue 2, p172
- ISSN
0915-5635
- Publication type
Article
- DOI
10.1111/den.14570