Objective To investigate the risk factors and predictive efficacy of re-gastrectomy after endoscopic submucosal dissection(ESD)in patients with early gastric cancer.Methods A total of 141 patients with early gastric cancer were retrospectively chosen from January 2017 to December 2022 in the Second People's Hospital of Jincheng.All patients were divided into the group of re-operation(35 cases)and the group of non-re-operation(106 cases)according to whether necessary to undergo re-gastrectomy to achieve the radical effect or not.The clinical characteristics of two groups were compared.The independent influencing factors of gastrectomy after ESD for early gastric cancer were analyzed by Logistic regression model.The clinical efficacy of predicting the risk of re-gastrectomy after ESD for early gastric cancer was evaluated by using receiver operating characteristic(ROC)curves.Results In the re-operation group,the percentage of positive margin after ESD(48.57％vs.8.49％),the eCura score was higher[(3.23±1.77)vs.(0.54±0.12)],and the percentage of concurrent ulcer(62.86％vs.17.92％)were significantly higher than those in the group without re-operation(P＜0.05).Multivariate analysis showed that higher eCura score(OR=850 343.336,95％CI:184.168-392.235 ×107)and the concurrent ulcer(OR=18.672,95％CI:1.472-236.801)were independent risk factors for re-gastrectomy after ESD(P＜0.05).Both the higher eCura score and the combination of ulcers after ESD could predict the risk of re-gastrectomy after ESD for early gastric cancer,and the combined prediction of the Youden's index(91.46％)was better than 44.93％,91.43％of the single index.Conclusion Gastrectomy after ESD for early gastric cancer is closely related to eCura score and the presence or absence of concurrent ulcers.The combination of high eCura score and concurrent ulcers can effectively predict the risk of gastric resection after ESD for early gastric cancer.
万方数据
维普
