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Table 2 Clinical outcomes of colorectal ESD according to body mass index groups

From: Impact of obesity in colorectal endoscopic submucosal dissection: single-center retrospective cohort study

 

Total

Control

(BMI*8 < 25 kg/m2)

Overweight

(25 kg/m2 ≤ BMI < 30 kg/m2)

Obese

(BMI ≥ 30 kg/m2)

P value

Lesion (n)

586

458

108

20

 

Operator, trainee (n)

327 (55.8%)

251 (54.8%)

64 (59.3%)

12 (60.0%)

0.653

Procedure time (min, median [IQR*1])

31.0 (20.0–53.0)

30.0 (20.0–50.8)

33.5 (22.0–60.0)

35.5 (24.5–48.0)

0.395

Longer procedure time (≥ 90 min) (n)

62 (10.6%)

42 (9.2%)

17 (15.7%)

3 (15.0%)

0.110

Specimen size (mm, median [IQR])

32.0 (24.0–40.0)

32.0 (25.0–40.0)

32.0 (26.0–40.0)

33.0 (24.0–41.3)

0.673

Lesion size (mm, median [IQR])

24.0 (20.0–30.0)

23.0 (20.0–30.0)

25.0 (20.0–32.0)

23.0 (16.0–32.5)

0.503

Use of hemostatic forceps (n)

53 (9.0%)

41 (9.4%)

9 (8.3%)

3 (15.0%)

0.627

Fibrosis (n)

 

0.878

 F0

472 (80.5%)

368 (80.3%)

89 (82.4%)

15 (75.0%)

 

 F1

76 (13.0%)

59 (12.9%)

14 (13.0%)

3 (15.0%)

 

 F2

38 (6.5%)

31 (6.8%)

5 (4.6%)

2 (10.0%)

 

En bloc resection (n)

585 (99.8%)

458 (100%)

107 (99.1%)

20 (100.0%)

0.109

Complete resection (n)

579 (98.8%)

454 (99.1%)

105 (97.2%)

20 (100.0%)

0.230

Curative resection (n)

573 (97.8%)

449 (98.0%)

104 (96.3%)

20 (100.0%)

0.430

Vertical margin positivity (n)

6 (1.0%)

4 (0.9%)

2 (1.9%)

0 (0.0%)

0.595

Horizontal margin positivity (n)

1 (0.2%)

0 (0.0%)

1 (0.9%)

0 (0.0%)

0.109

Tumor budding (n)

 

0.617

 Grade 1

52 (8.9%)

40 (8.7%)

10 (9.3%)

2 (10.0%)

 

 Grade 2, 3

2 (0.3%)

2 (0.4%)

0 (0.0%)

0 (0.0%)

 

Patients (n)

523

407

98

18

 

Change of vital signs during ESD (n)

 SBP fluctuation*2

110 (21.0%)

88 (21.6%)

27 (27.6%)

5 (27.8%)

0.403

 Bradycardia*3

30 (5.7%)

24 (5.9%)

5 (5.1%)

1 (5.6%)

0.905

 Hypoxemia*4

176 (33.7%)

123 (30.2%)

43 (43.9%)

10 (55.6%)

0.005

Amount of flunitrazepam

(mg/kg, median [IQR])

1.67 × 10−2

(1.22 × 10−2–2.27 × 10−2)

1.75 × 10−2

(1.27 × 10−2–2.34 × 10−2)

1.48 × 10−2

(1.08 × 10−2–2.03 × 10−2)

1.16 × 10−2

(0.98 × 10−2–1.54 × 10−2)

 < 0.001

Amount of pethidine

(mg/kg, median [IQR])

0.59 (0.51—0.69)

0.63 (0.55–0.72)

0.50 (0.46–0.56)

0.39 (0.32–0.45)

 < 0.001

Delayed bleeding (n)

7 (1.3%)

7 (1.7%)

0 (0.0%)

0 (0.0%)

0.314

Perforation (n)

4 (0.8%)

3 (0.7%)

1 (1.0%)

0 (0.0%)

0.893

PECS*5 (n)

5 (1.0%)

3 (2.6%)

2 (2.0%)

0 (0.0%)

0.450

Delayed event*6 (n)

 Pulmonary embolism

2 (0.4%)

1 (0.2%)

1 (1.0%)

0 (0.0%)

0.518

 Sick sinus syndrome

1 (0.2%)

0 (0.0%)

1 (1.0%)

0 (0.0%)

0.114

 Subarachnoid hemorrhage

1 (0.2%)

1 (0.2%)

0 (0.0%)

0 (0.0%)

0.867

Hospitalization*7

(days, median [IQR])

5.0 (5.0–5.0)

5.0 (5.0–5.0)

5.0 (5.0–5.0)

5.0 (5.0–5.0)

0.927

  1. *1 Interquartile range
  2. *2 Systolic blood pressure fluctuation of more than 50 mm Hg
  3. *3 Heart rate decreasing below 50 /min
  4. *4 Oxygen desaturation below 90%
  5. *5 Post-ESD coagulation syndrome
  6. *6 Adverse events other than bleeding and perforation that occurred within 30 days after ESD
  7. *7 Number of hospitalization days
  8. *8 Body mass index
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BMC Gastroenterology

ISSN: 1471-230X

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