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Table 3 Clinical outcome of colorectal ESD performed by trainees 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)

327

251

64

12

 

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

40.0 (26.0–60.0)

40.0 (25.0–59.0)

47.0 (30.0–74.3)

38.0 (30.8–63.0)

0.150

Longer procedure time (≥ 90 min) (n)

44 (13.5%)

27 (10.8%)

14 (21.9%)

3 (25.0%)

0.033

Specimen size (mm, min, median [IQR])

30.0 (24.5–38.0)

30.0 (24.0–37.0)

30.0 (25.8–40.0)

29.5 (23.5–36.0)

0.456

Lesion size (mm mean ± SD)

22.0 (19.0–29.0)

22.0 (18.5–28.0)

24.5 (19.8–32.0)

20.0 (16.0–29.0)

0.274

Fibrosis (n)

 

0.942

 F0

277 (84.7%)

214 (85.3%)

53 (82.8%)

10 (83.3%)

 

 F1

33 (10.1%)

24 (9.6%)

8 (12.5%)

1 (8.3%)

 

 F2

17 (5.2%)

13 (5.2%)

3 (4.7%)

1 (8.3%)

 

Self-completion (n)

279 (85.3%)

218 (86.0%)

51 (79.7%)

10 (83.3%)

0.345

En bloc resection (n)

326 (99.7%)

251 (100%)

63 (98.4%)

12 (100.0%)

0.127

Complete resection (n)

322 (98.5%)

249 (99.2%)

61 (95.3%)

12 (100.0%)

0.070

Curative resection (n)

317 (96.9%)

245 (97.6%)

60 (93.8%)

12 (100.0%)

0.228

Vertical margin positivity (n)

4 (1.2%)

2 (0.8%)

2 (3.1%)

0 (0.0%)

0.295

Horizontal margin positivity (n)

1 (0.3%)

0 (0.0%)

1 (1.6%)

0 (0.0%)

0.127

Tumor budding (n)

 

0.862

 Grade 1

29 (8.9%)

21 (8.4%)

6 (9.4%)

2 (16.7%)

 

 Grade 2, 3

1 (0.3%)

1 (0.4%)

0 (0.0%)

0 (0.0%)

 

Patients (n)

288

221

56

11

 

Change of vital signs during ESD (n)

 SBP fluctuation*2

77 (26.7%)

57 (25.8%)

17 (30.4%)

3 (27.3%)

0.788

 Bradycardia*3

21 (7.3%)

16 (7.2%)

5 (8.9%)

0 (0.0%)

0.580

 Hypoxemia*4

110 (38.2%)

77 (34.8%)

27 (48.2%)

6 (54.5%)

0.096

Amount of flunitrazepam

(mg/kg, median [IQR]*4)

1.73 × 10−2

(1.27 × 10−2–2.26 × 10−2)

1.77 × 10−2

(1.32 × 10−2–2.29 × 10−2)

1.55 × 10−2

(1.17 × 10−2–2.23 × 10−2)

1.33 × 10−2

(1.21 × 10−2–1.98 × 10−2)

0.197

Amount of pethidine

(mg/kg, median [IQR])

0.58 (0.51–0.66)

0.61 (0.54–0.69)

0.49 (0.47–0.56)

0.38 (0.33–0.46)

 < 0.001

Delayed bleeding (n)

6 (2.1%)

6 (2.7%)

0 (0.0%)

0 (0.0%)

0.395

Perforation (n)

3 (1.0%)

2 (0.9%)

1 (1.8%)

0 (0.0%)

0.796

PECS*5 (n)

3 (1.0%)

1 (0.5%)

2 (3.6%)

0 (0.0%)

0.114

Delayed event*6 (n)

 Pulmonary embolism

1 (0.3%)

0 (0.0%)

1 (1.8%)

0 (0.0%)

0.125

 Sick sinus syndrome

1 (0.3%)

0 (0.0%)

1 (1.8%)

0 (0.0%)

0.125

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)

0.721

  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