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Landscape of esophageal submucosal tunneling endoscopic resection-related adverse events in a standardized lexicon: a large volume of 1701 cases

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Abstract

Background

Submucosal tunneling endoscopic resection (STER) has been widely applied for esophageal submucosal tumors. This large volume study aims to provide a standard landscape of STER-related AEs for reference.

Methods

1701 patients with esophageal SMTs undergoing STER were included at Zhongshan Hospital, Fudan University. Data of clinical characteristics and adverse events were collected and analyzed in depth. Adverse events were recorded by ASGE lexicon and graded by ASGE grading/Clavien–Dindo system. Risk factors for major AEs were analyzed by univariate and multivariate logistic regression.

Results

Three hundred and twenty (18.8%) patients with 962 cases of adverse events were observed. Accordingly, 84 (5.0%) were classified as major AEs (moderate and severe) by ASGE grading and 37 (2.2%) were classified as major AEs (grades III–V) by Clavien–Dindo grading. First 1 year operation, distance > 6 cm from incision to tumor, piecemeal resection, partially extraluminal location, mucosal injury, and operation time > 60 min were included in the risk score model for major AEs of STER, with 57.1% sensitivity and 87.5% specificity.

Conclusions

STER was a safe procedure for diagnosis and treatment of esophageal SMTs with a total 18.8% incidence of AEs, among which only 5.0% were major AEs requiring therapeutic measurements.

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Abbreviations

STER:

Submucosal tunnel endoscopic resection

AE:

Adverse event

SMT:

Submucosal tumor

GIST:

Gastrointestinal stromal tumor

ASGE:

American society of gastrointestinal endoscopy

EUS-FNA:

Endoscopic ultrasound fine-needle aspiration

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Funding

This study was supported by grants from the National Key R&D Program of China (2019YFC1315800), National Natural Science Foundation of China (81873552, 82003074, and 81670483), Shanghai Rising-Star Program (19QA1401900), Major Project of Shanghai Municipal Science and Technology Committee (18ZR1406700, 19441905200, and 16DZ2280900), and Shanghai Sailing Program of Shanghai Municipal Science and Technology Committee (2018YF1403700).

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Author notes

  1. Jia-Qi Xu, Jia-Xin Xu, Xiao-Yue X, and Lu Yao shared co-first authorship.

Authors and Affiliations

  1. Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China

    Jia-Qi Xu, Jia-Xin Xu, Xiao-Yue Xu, Lu Yao, Mei-Dong Xu, Shi-Yao Chen, Yun-Shi Zhong, Yi-Qun Zhang, Wei-Feng Chen, Jian-Wei Hu, Ming-Yan Cai, Li-Qing Yao, Quan-Lin Li & Ping-Hong Zhou

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  1. Jia-Qi Xu
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Contributions

All the authors made substantial contributions to the conception or design of the work (Q-LL, P-HZ); the acquisition, analysis (M-DX, S-YC, Y-SZ, Y-QZ, W-FC, J-WH, M-YC, L-QY), and interpretation of data for the work (J-QX, J-XX, X-YX, LY); drafted (J-QX, J-XX, X-YX, LY) the work or revised (Q-LL, P-HZ, M-DX, S-YC, Y-SZ, Y-QZ, W-FC, J-WH, M-YC, L-QY) it critically for important intellectual content; and they all gave final approval of the version to be published; and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding authors

Correspondence to Quan-Lin Li or Ping-Hong Zhou.

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Disclosures

Jia-Qi Xu, Jia-Xin Xu, Xiao-Yue Xu, Lu Yao, Mei-Dong Xu, Shi-Yao Chen, Yun-Shi Zhong, Yi-Qun Zhang, Wei-Feng Chen, Jian-Wei Hu, Ming-Yan Cai, Li-Qing Yao, Quan-Lin Li, and Ping-Hong Zhou declared no conflict of interest.

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Ping-Hong Zhou is accepting full responsibility for the conduct of the study. He had access to the data and have control of the decision to publish.

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Xu, JQ., Xu, JX., Xu, XY. et al. Landscape of esophageal submucosal tunneling endoscopic resection-related adverse events in a standardized lexicon: a large volume of 1701 cases. Surg Endosc 36, 8112–8120 (2022). https://doi.org/10.1007/s00464-022-09241-7

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  • DOI: https://doi.org/10.1007/s00464-022-09241-7

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