Details

Autor(en) / Beteiligte

• Choi, Young Kwon
• Ahn, Ji Yong
• Na, Hee Kyong
• Jung, Kee Wook
• Kim, Do Hoon
• Lee, Jeong Hoon
• Choi, Kee Don
• Song, Ho June
• Lee, Gin Hyug
• Jung, Hwoon-Yong

Titel

Outcomes of endoscopic submucosal dissection for gastric epithelial neoplasm in chronic kidney disease patients: propensity score-matched case–control analysis

Ist Teil von

• Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association, 2019-01, Vol.22 (1), p.164-171

Ort / Verlag

Tokyo: Springer Japan

Erscheinungsjahr

2019

Quelle

MEDLINE

Beschreibungen/Notizen

• Background Little is known about the outcomes of gastric endoscopic submucosal dissection (ESD) in patients with chronic kidney disease (CKD). We compared the efficacy and safety of ESD between CKD and non-CKD patients. Methods From January 2005 to December 2014, 102 CKD patients underwent ESD for gastric neoplasms at a tertiary medical institution were reviewed retrospectively. A propensity score-matched control group (102 patients) was selected from non-CKD patients to compare clinical outcomes between CKD and non-CKD patients. Results En bloc resection (96.1%) and curative resection (88.2%) rates in the CKD group did not significantly differ from those in the non-CKD group. Median procedure times (25.0 vs. 21.5 min, p  = 0.734) and perforation risk ( p  = 0.480) were similar between groups. The CKD group showed a tendency towards more bleeding events ( p  = 0.052) and had a significantly longer hospital stay ( p  = 0.001). In a subgroup analysis, stage 3 CKD patients exhibited a bleeding risk comparable to that exhibited by non-CKD patients (HR 1.35; 95% CI 0.36–5.06; p  = 0.654), whereas stage 4 (HR 5.79; 95% CI 1.52–22.0; p  = 0.010) and stage 5 (HR 4.80; 95% CI 1.58–14.6; p  = 0.006) patients showed higher bleeding risks than non-CKD patients. In a multivariate analysis, stage 4/5 CKD was a significant predictor for bleeding risk (HR 4.99; 95% CI 1.32–18.8; p  = 0.018). Conclusions ESD for gastric epithelial neoplasms can be performed in stage 3 CKD patients with comparable efficacy and safety to that performed in non-CKD patients. Stage 4 and 5 CKD patients should be closely monitored for bleeding events after ESD.