Impact of prior abdominal surgery on post-polypectomy complications following endoscopic mucosal resection and endoscopic submucosal dissection

doi:10.4240/wjgs.v18.i3.114720

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Mar 27, 2026 (publication date) through Mar 30, 2026

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Cohort Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Surg. Mar 27, 2026; 18(3): 114720
Published online Mar 27, 2026. doi: 10.4240/wjgs.v18.i3.114720

Table 1 Baseline characteristics of the study cohort, mean ± SD/n (%)

Variable	PAS (n = 31)	NPAS (n = 49)	χ²/t	P value
Sex			0.024	0.877
Male	17 (54.84)	26 (53.06)
Female	14 (45.16)	23 (46.94)
Ages (olds)	56.73 ± 8.12	57.80 ± 8.09	0.576	0.567
BMI (kg/m²)	23.45 ± 2.10	22.70 ± 1.89	1.656	0.102
Smoking history	17 (54.84)	19 (38.78)	1.614	0.204
Alcohol consumption	9 (29.03)	13 (26.53)	0.060	0.807
Comorbidities
Arterial hypertension	18 (58.07)	16 (32.65)	5.017	0.025
Type 2 diabetes mellitus	10 (32.26)	8 (16.33)	2.764	0.096
Hyperlipidemia	12 (38.71)	7 (14.29)	6.255	0.012
Anticoagulant/antiplatelet therapy	15 (48.39)	9 (18.37)	8.148	0.004

BMI: Body-mass index; PAS: Prior abdominal surgery; NPAS: Non-prior abdominal surgery.

Full Size Table

Table 2 Comparison of polyposis lesions and surgical-related indicators between two patient groups, mean ± SD/n (%)

Variable	PAS (n = 31)	NPAS (n = 49)	χ²/t	P value
Polyp location			0.192	0.661
Left colon	18 (58.07)	26 (53.06)
Right colon	13 (41.93)	23 (46.94)
Polyp size (mm)	16.45 ± 4.98	13.20 ± 4.67	2.956	0.004
Number of polyps	1.87 ± 0.72	1.52 ± 0.39	2.818	0.006
Polyp morphology			0.298	0.585
Pedunculated	12 (38.71)	22 (44.90)
Sessile	19 (61.29)	27 (55.10)
Resection modality			6.140	0.013
EMR	15 (48.39)	37 (75.51)
ESD	16 (51.61)	12 (24.49)
Procedure duration (minutes)	45.29 ± 11.13	33.70 ± 10.57	4.681	0.000
Prophylactic clip deployment	25 (80.65)	22 (44.90)	10.010	0.002

EMR: Endoscopic mucosal resection; ESD: Endoscopic submucosal dissection; PAS: Prior abdominal surgery; NPAS: Non-prior abdominal surgery.

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Table 3 Comparison of postoperative recovery indicators between two patient groups, mean ± SD

Variable	PAS (n = 31)	NPAS (n = 49)	t	P value
Length of stay (days)	8.19 ± 2.16	5.76 ± 1.78	5.472	0.000
Time to resumption of oral intake (days)	4.06 ± 1.35	2.69 ± 0.93	5.376	0.000
Time to mobilization (days)	5.38 ± 1.72	3.89 ± 1.35	4.319	0.000
Post-operative VAS score	5.24 ± 1.28	3.27 ± 1.06	7.467	0.000

VAS: Visual Analogue Scale; PAS: Prior abdominal surgery; NPAS: Non-prior abdominal surgery.

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Table 4 Comparison of postoperative complication rates between the two patient groups, n (%)

Groups	n	Hemorrhage	Perforation	Pyrexia	Infection	Abdominal pain	Complications
PAS	31	6 (19.35)	4 (12.90)	3 (9.68)	4 (12.90)	8 (35.48)	25 (80.65)
NPAS	49	5 (10.20)	2 (4.08)	4 (8.16)	3 (6.12)	8 (16.33)	22 (44.90)
χ²							10.010
P value							0.002

PAS: Prior abdominal surgery; NPAS: Non-prior abdominal surgery.

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Table 5 Multivariate logistic regression analysis of postoperative complications following endoscopic polypectomy

Variable	β	SE	Wald χ²	P value	OR	95%CI
Hypertension	1.049	0.475	4.888	0.027	2.856	1.126-7.240
Hyperlipidemia	1.332	0.550	5.865	0.015	3.790	1.289-11.139
Anticoagulant/antiplatelet therapy	1.427	0.515	7.678	0.006	4.167	1.518-11.434
Prior abdominal surgery	1.437	0.517	7.733	0.005	4.208	1.528-11.585
Polyp size	0.145	0.053	7.316	0.006	1.156	1.041-1.283
Polyp number	1.030	0.425	5.867	0.015	2.801	1.217-6.447
Resection modality	1.191	0.489	5.918	0.015	3.289	1.260-8.583
Procedure duration	0.104	0.028	13.896	0.000	1.110	1.051-1.172
Prophylactic clip deployment	1.632	0.538	9.210	0.002	5.114	1.782-14.671

OR: Odds ratio; CI: Confidence interval.

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Table 6 Assessment of the value of various factors in predicting postoperative complications in patients undergoing endoscopic polypectomy

Variable	AUC	95%CI	Sensitivity (%)	Specificity (%)	Maximum Youden index
Hypertension	0.627	0.500-0.754	73.53	90.00	0.635
Hyperlipidemia	0.622	0.492-0.752	70.59	80.00	0.506
Anticoagulant/antiplatelet therapy	0.650	0.522-0.778	67.65	95.36	0.630
Prior abdominal surgery	0.663	0.541-0.784	77.42	55.10	0.325
Polyp size	0.670	0.547-0.792	41.94	85.71	0.277
Polyp number	0.633	0.506-0.759	70.91	48.98	0.200
Resection modality	0.636	0.508-0.763	51.61	75.51	0.271
Procedure duration	0.777	0.671-0.883	67.74	83.67	0.514
Prophylactic clip deployment	0.679	0.560-0.798	80.65	55.10	0.358

AUC: Area under the curve; CI: Confidence interval.

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Citation: Wu QF, Huang ZQ, Yu ZH, Li JT, Huang L. Impact of prior abdominal surgery on post-polypectomy complications following endoscopic mucosal resection and endoscopic submucosal dissection. World J Gastrointest Surg 2026; 18(3): 114720
URL: https://www.wjgnet.com/1948-9366/full/v18/i3/114720.htm
DOI: https://dx.doi.org/10.4240/wjgs.v18.i3.114720