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- Title
FA03.03: RISK FACTORS FOR MALLORY-WEISS TEAR DURING ENDOSCOPIC SUBMUCOSAL DISSECTION OF SUPERFICIAL ESOPHAGEAL NEOPLASMS.
- Authors
Chen, Wei; Wu, Junchao; Gan, Tao; Yang, Jinlin
- Abstract
Background Adverse events such as perforation and bleeding during endoscopic submucosal dissection (ESD) of superficial esophageal neoplasms have been well acquainted. However, Mallory Weiss Tear (MWT) during esophageal ESD is still under obscurity. Therefore, this study was carried out to elucidate the incidence and risk factors for MWT during esophageal ESD. Methods Patients received ESD for superficial esophageal neoplasms from June, 2014 to July 2017 in our institution were retrospectively analyzed. Clinicopathological characteristics of the patients were collected. Patients were allocated into MWT group or non-MWT group based on the presence of MWT occurred during ESD. The incidence of MWT was determined and the risk factors for MWT were identified. Results A total of 337 patients with 373 lesions treated by ESD were analyzed. 20 patients developed MWT during ESD (5.4%). Multivariate analysis identified female gender (OR = 5.36, 95%CI: 1.47–19.50, P = 0.011) and procedure time (OR = 1.01, 95%CI: 1.00–1.02, P = 0.048) were independent risk factors for MWT during ESD. The characteristics of the esophageal lesions had no influence on the development of MWT. The vast majority of patients with MWT did not receive endoscopic treatment for the laceration and seven of the MWT patients received endoscopic hemostasis using APC, hemoclips, or hemoclips combined with endoloop. All the patients recovered satisfactorily without surgery for the laceration. We believe the placement of gastrointestinal decompression tube and the use of PPI and hemostatic drugs after ESD contributed to the hemostasis and mucosal healing. Conclusion The incidence of MWT during esophageal ESD was much higher than expected. Although most cases had a benign course, fetal conditions such as massive hemorrhage may also occur. We recommend an inspection of the stomach after ESD procedure in order to take timely management in case of bleeding MWT or even perforation outside the procedure region. Disclosure All authors have declared no conflicts of interest.
- Subjects
ENDOSCOPIC hemostasis; TUMORS; DISSECTION; MULTIVARIATE analysis
- Publication
Diseases of the Esophagus, 2018, Vol 31, Issue 13, p6
- ISSN
1120-8694
- Publication type
Article
- DOI
10.1093/dote/doy089.FA03.03