Factors influencing development of non-cardiac chest pain after endoscopic submucosal dissection for esophageal neoplasms: a retrospective case–control study of 309 patients from a single center

2021 ◽  
Author(s):  
Dian Zhao ◽  
Ying Liu ◽  
Lei Wang ◽  
Guifang Xu ◽  
Ying Lv ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chest Pain ◽  
Endoscopic Submucosal Dissection ◽  
Esophageal Neoplasms ◽  
Precancerous Lesions ◽  
Previous Surgery ◽  
Postoperative Fever ◽  
Submucosal Dissection ◽  
Hospitalization Time ◽  
History Of

Summary Endoscopic submucosal dissection (ESD) is widely used for early stage esophageal cancer and precancerous lesions. Non-cardiac chest pain (NCCP) is a frequent complication of ESD. However, little is known about its incidence and associated factors. This study investigated the pain incidence and predictive factors for pain development after ESD for esophageal neoplasms. We enrolled a total of 309 patients with esophageal neoplasms, who underwent ESD in our center from January 2018 to June 2019. Sociodemographic and clinicopathological information for all patients was collected, and patients were divided into either a pain-free group (n = 156) or a pain group (n = 153) according to whether there was onset of NCCP 24–48 hours after surgery. We made comparisons between groups using Student’s t test or the χ2 test. Logistic-regression analysis was used to screen for risk factors. There were statistically significant differences in histories of previous surgery (P = 0.039), lesion size (P = 0.026), operation time (P = 0.009), and postoperative fever (P = 0.001). History of previous surgery (P = 0.043) and postoperative fever (P = 0.007) were independent risk factors for chest pain after esophageal ESD treatment. Chest pain and fever prolonged postoperative hospitalization time (P = 0.005, P = 0.001) and increased hospitalization cost (P = 0.034, P < 0.001). A history of previous surgery and postoperative fever was associated with the occurrence of NCCP after ESD in patients with esophageal neoplasms. NCCP and fever after esophageal ESD increased both hospitalization time and cost.

FA03.03: RISK FACTORS FOR MALLORY-WEISS TEAR DURING ENDOSCOPIC SUBMUCOSAL DISSECTION OF SUPERFICIAL ESOPHAGEAL NEOPLASMS

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 6-6
Author(s):  
Wei Chen ◽  
Junchao Wu ◽  
Tao Gan ◽  
Jinlin Yang
Keyword(s):  
Risk Factors ◽  
Endoscopic Submucosal Dissection ◽  
Esophageal Neoplasms ◽  
Conflicts Of Interest ◽  
Female Gender ◽  
Mucosal Healing ◽  
Clinicopathological Characteristics ◽  
Massive Hemorrhage ◽  
Submucosal Dissection ◽  
Decompression Tube

Abstract Background Adverse events such as perforation and bleeding during endoscopic submucosal dissection (ESD) of superficial esophageal neoplasms have been well acquainted. However, Mallory Weiss Tear (MWT) during esophageal ESD is still under obscurity. Therefore, this study was carried out to elucidate the incidence and risk factors for MWT during esophageal ESD. Methods Patients received ESD for superficial esophageal neoplasms from June, 2014 to July 2017 in our institution were retrospectively analyzed. Clinicopathological characteristics of the patients were collected. Patients were allocated into MWT group or non-MWT group based on the presence of MWT occurred during ESD. The incidence of MWT was determined and the risk factors for MWT were identified. Results A total of 337 patients with 373 lesions treated by ESD were analyzed. 20 patients developed MWT during ESD (5.4%). Multivariate analysis identified female gender (OR = 5.36, 95%CI: 1.47–19.50, P = 0.011) and procedure time (OR = 1.01, 95%CI: 1.00–1.02, P = 0.048) were independent risk factors for MWT during ESD. The characteristics of the esophageal lesions had no influence on the development of MWT. The vast majority of patients with MWT did not receive endoscopic treatment for the laceration and seven of the MWT patients received endoscopic hemostasis using APC, hemoclips, or hemoclips combined with endoloop. All the patients recovered satisfactorily without surgery for the laceration. We believe the placement of gastrointestinal decompression tube and the use of PPI and hemostatic drugs after ESD contributed to the hemostasis and mucosal healing. Conclusion The incidence of MWT during esophageal ESD was much higher than expected. Although most cases had a benign course, fetal conditions such as massive hemorrhage may also occur. We recommend an inspection of the stomach after ESD procedure in order to take timely management in case of bleeding MWT or even perforation outside the procedure region. Disclosure All authors have declared no conflicts of interest.

scholarly journals Identification of clinical features associated with mortality in COVID-19 patients

2021 ◽  
Author(s):  
Rahimeh Eskandarian ◽  
Zahra Alizadeh Sani ◽  
Mohaddeseh Behjati ◽  
Mehrdad Zahmatkesh ◽  
Azadeh Haddadi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Abdominal Pain ◽  
Chest Pain ◽  
Clinical Features ◽  
Neurological Disorders ◽  
Tertiary Hospital ◽  
Multiple Risk Factors ◽  
Hospitalization Time ◽  
History Of ◽  
Multiple Risk

Background To prevent infectious diseases, it is necessary to understand how they are spread and their clinical features. Early identification of risk factors and clinical features is needed to identify critically ill patients, provide suitable treatments, and prevent mortality. Methods We conducted a prospective study on COVID-19 patients referred to a tertiary hospital in Iran between March and November 2020. Of the 3008 patients (mean age 59.3 years, range 1 to 100 years), 1324 were women. We investigated COVID-19 related mortality and its association with clinical features including headache, chest pain, symptoms on CT, hospitalization, time to infection, history of neurological disorders, having a single or multiple risk factors, fever, myalgia, dizziness, seizure, abdominal pain, nausea, vomiting, diarrhoea and anorexia. Findings There was a significant association between COVID-19 mortality and old age, headache, chest pain, respiratory distress, low respiratory rate, oxygen saturation less than 93%, need for a mechanical ventilator, having symptoms on CT, hospitalization, time to infection, history of hypertension, neurological disorders, cardiovascular diseases and having a risk factor or multiple risk factors. In contrast, there was no significant association between mortality and gender, fever, myalgia, dizziness, seizure, abdominal pain, nausea, vomiting, diarrhoea and anorexia. Interpretation Our results might help identify early symptoms related to COVID-19 and better manage patients clinically.

scholarly journals Risk factors for Mallory-Weiss Tear during endoscopic submucosal dissection of superficial esophageal neoplasms

2019 ◽  
Vol 25 (34) ◽  
pp. 5174-5184
Author(s):  
Wei Chen ◽  
Xiao-Nan Zhu ◽  
Jin Wang ◽  
Lin-Lin Zhu ◽  
Tao Gan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Endoscopic Submucosal Dissection ◽  
Esophageal Neoplasms ◽  
Submucosal Dissection

scholarly journals Effect of Endoscopic Submucosal Dissection for Superficial Esophageal Neoplasms and Risk Factors for Postoperative Stricture

Medicine ◽  
2015 ◽  
Vol 94 (1) ◽  
pp. e373 ◽  
Author(s):  
Keita Funakawa ◽  
Hirofumi Uto ◽  
Fumisato Sasaki ◽  
Yuichiro Nasu ◽  
Seiichi Mawatari ◽  
...  
Keyword(s):  
Risk Factors ◽  
Endoscopic Submucosal Dissection ◽  
Esophageal Neoplasms ◽  
Submucosal Dissection

scholarly journals Chest Pain and Exercise Induced Ischemia with Angiographically Insignificant Coronary Arterial Disease: Clinical Presentation and Follow-Up

1970 ◽  
Vol 6 (1) ◽  
pp. 27-31
Author(s):  
Md Khurshed Ahmed ◽  
Mohammad Salman ◽  
Md Ashraf Uddin Sultan ◽  
Md Abu Siddique ◽  
KMHS Sirajul Haque ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Chest Pain ◽  
Stress Test ◽  
Exercise Stress Test ◽  
Exercise Stress ◽  
Coronary Angiogram ◽  
Ecg Changes ◽  
History Of

Angiography of patients with typical chest pain reveals normal epicardial coronary arteries in about 15-20%. ECG changes suggestive of myocardial ischemia during exercise also can be demonstrated in this subset of the patients. Total 58 patients (42 females) with mean age 42±7 years who were undergoing coronary angiogram in the Department of Cardiology, University Cardiac Center, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from January 2005 to December 2009 were evaluated. The patients were recruited on the basis of presence of history of chest pain, with normal resting ECG and ischemia like ECG changes during exercise stress test. 32.8% patients had hypertension and 15.5% were diabetics, 19.0% had dyslipidemia and 6.9% had family history of ischemic heart disease. All the patients were having positive exercise stress test. Angiographic findings showed luminal irregularities in 29.3% patients, 15.5% patients had luminal stenosis less than 30% and rest had normal coronary angiogram. Follow up of the patients after one and six months of angiogram was done. After one month 63.8% patients remained symptomatic and after six months 63.3% patients remained symptomatic despite maximum medical management. The pathophysiology and appropriate management of this subset of the patients still remained a challenge for physicians. Optimum management of cardiovascular risk factors is very important issue in this group of patients.Key words: Angiography; Epicardial coronary arteries; Exercise stress test; Cardiovascular risk factors. DOI: 10.3329/uhj.v6i1.7187University Heart Journal Vol.6(1) 2010 pp.27-31

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