RT Journal Article
T1 Switching from endoscopic submucosal dissection to salvage piecemeal knife-assisted snare resection to remove a lesion: a preoperative risk score from the beginning
A1 Marín Gabriel, José Carlos
A1 Lora Pablos, David
A1 Díaz Tasende, José Benjamín
A1 Cancelas Navia, Pilar
A1 Roríguez Muñoz, Sarbelio
A1 Pozo García, Andrés J. Del
A1 Alonso Riaño, Marina
A1 Rodríguez Gil, Yolanda
A1 Ibarrola De Andrés, Carolina Natalia
A1 Castellano Tortajada, Gregorio
AB Background and aims: endoscopic submucosal dissection (ESD) in the Western setting remains a challenge. Therefore, other simplified techniques such as knife-assisted snare resection (KAR) have been reported to overcome this issue. Methods: patients who underwent an ESD for the treatment of gastrointestinal neoplasms were included in a retrospective cross-sectional observational study. Factors associated with the end of ESD as a salvage p-KAR were identified and a logistic regression model was developed. Results: a total of 136 lesions in 133 patients were analyzed. Operator experience of under 50 cases and the combination of lesion size > 30 mm and colorectal location were independent predictive factors for switching to a salvage p-KAR according to the multivariate logistic regression analysis. We developed a risk scoring system based on these four variables (experience, size, location and the combination of size and location) with a receiver operating characteristic curve of 0.81 (95% CI: 0.74-0.89). The diagnostic accuracy of the score for a cut-off point ≥ 5 had a sensitivity of 0.79 (95% CI: 0.66-0.93) and a specificity of 0.71 (95% CI: 0.61-0.80). Conclusion: a simple predictive score system that includes four preoperative factors accurately predicts ESD to finish as a p-KAR. A careful selection of cases considering these variables could be useful to achieve better outcomes in the Western setting.
PB Sociedad Española de Patología Digestiva
SN 1130-0108
YR 2018
FD 2018
LK https://hdl.handle.net/20.500.14352/130681
UL https://hdl.handle.net/20.500.14352/130681
LA eng
NO Marín-Gabriel, J. C., Lora Pablos, D., Díaz-Tasende, J., Cancelas-Navia, P., Rodríguez Muñoz, S., Del Pozo-García, A. J., Alonso-Riaño, M., Rodríguez-Gil, Y., Ibarrola-Andrés, C., & Castellano Tortajada, G. (2018). Switching from endoscopic submucosal dissection to salvage piecemeal knife-assisted snare resection to remove a lesion: A preoperative risk score from the beginning. Revista espanola de enfermedades digestivas, 110(11), 699–705. https://doi.org/10.17235/reed.2018.5608/2018
DS Docta Complutense
RD 26 feb 2026