2026-06-29T07:50:31Zhttps://docta.ucm.es/rest/oai/request

oai:docta.ucm.es:20.500.14352/1306812026-01-22T01:02:29Zcom_20.500.14352_14col_20.500.14352_15

Switching from endoscopic submucosal dissection to salvage piecemeal knife-assisted snare resection to remove a lesion: a preoperative risk score from the beginning Marín Gabriel, José Carlos Lora Pablos, David Díaz Tasende, José Benjamín Cancelas Navia, Pilar Roríguez Muñoz, Sarbelio Pozo García, Andrés J. Del Alonso Riaño, Marina Rodríguez Gil, Yolanda Ibarrola De Andrés, Carolina Natalia Castellano Tortajada, Gregorio 61 Endoscopic submucosal dissection Endoscopic mucosal resection Predictive value Sensitivity and specificity ROC curve Area under curve Ciencias Biomédicas 32 Ciencias Médicas 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. Depto. de Medicina Fac. de Medicina TRUE pub 2026-01-21T09:15:27Z 2026-01-21T09:15:27Z 2018 journal article VoR https://hdl.handle.net/20.500.14352/130681 1130-0108 10.17235/reed.2018.5608/2018 eng 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 restricted access application/pdf Sociedad Española de Patología Digestiva