Outcomes of endoscopic submucosal dissection in cirrhotic patients: First American cohort

Table 1 Baseline characteristics of the cirrhotic and non-cirrhotic cohorts, n (%)/ mean ± SD

	Cirrhosis (16 patients, 19 procedures)	Controls (43 patients, 45 procedures)	P value
Age (yr)	66.38 ± 8.08	64.81 ± 11.50	0.57
Gender (male)	10 (62.50)	28 (65.12)	0.85
Race (white)	14 (87.5)	33 (76.74)	0.36
Anticoagulation (yes)	0	7 (15.5)	0.09
Intraprocedural diameter (mm)	39.21 ± 13.21	43.44 ± 20.49	0.34
Fibrosis (yes)	4 (25)	14 (31.11)	0.55
Location of lesion
Colorectal	5 (26.32)	13 (28.89)	0.83
Stomach	3 (15.79)	6 (13.33)	0.80
Esophagus	10 (52.63)	24 (53.33)	0.96
Duodenum	1 (5.26)	2 (4.44)	0.89
Child Classification
A	10 (62.5)
B	3 (18.75)
C	1 (6.25)
Unspecified	2 (12.5)
Paris IIc (depressed) lesion	5 (26.32)	12 (26.67)	0.98

Table 2 Procedural outcomes of cirrhotic and non-cirrhotic cohorts, n (%)

	Cirrhosis (16 patients, 19 procedures)	Controls (43 patients, 45 procedures)	P value
Primary outcomes
En bloc resection	16 (84.21)	40 (88.89)	0.61
R0 resection	15 (78.94)	31 (68.89)	0.41
Curative resection	14 (73.68)	29 (64.44)	0.47
Procedure duration (mean ± SD; min)	89.32 ± 40.61	97.62 ± 57.3	0.52
Follow-up	10 (52.63)	19 (42.22)	0.44
Recurrence	4 (40)	1 (5.26)	0.019
Adverse events
Any adverse event	4 (21.05)	5 (12.5)	0.30
Surgery for any cause	2 (10.52)	4 (9.76)	0.83
Admitted	7 (36.84)	26 (57.78)	0.13
Pneumoperitoneum/pneumomediastinum	1 (5.26)	2 (4.44)	0.89
Micro-perforation	0	1 (2.22)	1.00
Delayed bleeding (yes)	1 (5.26)	5 (11.11)	0.46
Procedural characteristics
Closure (yes)	12 (63.16)	21 (46.67)	0.23
Use of traction (yes)	1 (5.26)	3 (6.67)	0.83
Use of a stabilization device (yes)	4 (21.05)	3 (6.67)	0.09
Use of coagrasper (yes)	9 (47.37)	9 (20)	0.026
Coagrasper use by location
Colorectal	3 (60)	0	0.012
Stomach	2 (66.66)	2 (33.33)	0.34
Esophagus	4 (40)	7 (29.17)	0.54
Duodenum	0	0

Table 3 Multivariate regression analysis

Risk of recurrence at follow up	Odds ratio	Robust standard error	P value	Lower bound of 95%CI	Upper bound of 95%CI
Lesion size in mm	1.03	0.19	0.103	0.99	1.06
Cirrhosis	13.77	18.95	0.057	0.92	204.47
Bleeding requiring coagulation grasper use	0.51	0.0.57	0.554	0.056	4.66
Presence of fibrosis	0.73	0.90	0.802	0.06	8.25