Influence of hospital volume on bleeding after endoscopic submucosal dissection for early gastric cancer in Japan: a multicenter propensity score-matched analysis

Yohei Yabuuchi, Waku Hatta, Yosuke Tsuji, Toshiyuki Yoshio, Naomi Kakushima, Shu Hoteya, Hisashi Doyama, Yasuaki Nagami, Takuto Hikichi, Masakuni Kobayashi, Yoshinori Morita, Tetsuya Sumiyoshi, Mikitaka Iguchi, Hideomi Tomida, Takuya Inoue, Tatsuya Mikami, Kenkei Hasatani, Jun Nishikawa, Tomoaki Matsumura, Hiroko NebikiDai Nakamatsu, Ken Ohnita, Haruhisa Suzuki, Hiroya Ueyama, Yoshito Hayashi, Mitsushige Sugimoto, Shinjiro Yamaguchi, Tomoki Michida, Tomoyuki Yada, Yoshiro Asahina, Toshiaki Narasaka, Shiko Kuribayashi, Shu Kiyotoki, Katsuhiro Mabe, Mitsuhiro Fujishiro, Atsushi Masamune, Hiroyuki Ono

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Information on whether there is a relationship between hospital volume and bleeding after endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) is limited. This study aimed to compare the bleeding rates after ESD for EGC according to the hospital volume. Methods: Patients who underwent ESD for EGC at 33 institutions in Japan between November 2013 and October 2016 were included in this multicenter retrospective study. Hospital volume was categorized into three groups, based on the average annual number of ESD procedures: low- and medium-volume group (LMVG), high-volume group (HVG), and very high-volume group (VHVG). The bleeding rate after ESD for EGC was compared between the three hospital volume groups after propensity score matching. Results: A total of 10,320 patients, including 2797 patients in the LMVG, 4646 patients in the HVG, and 2877 patients in the VHVG, were identified. Propensity score matching yielded 2002 patients in each hospital volume group, with an improved balance of confounding variables between the three groups. The bleeding rates in the LMVG, HVG, and VHVG were 4.3%, 3.7%, and 4.9%, respectively, and no significant difference was noted between the three groups. Conclusions: The bleeding rate after ESD for EGC did not differ between hospitals in Japan. The finding indicated that ESD for EGC is equally feasible across Japanese hospitals of different volumes regarding bleeding after ESD.

Original languageEnglish
JournalSurgical endoscopy
DOIs
Publication statusAccepted/In press - 2021

Keywords

  • Bleeding
  • Early gastric cancer
  • Endoscopic submucosal dissection
  • Hospital volume

ASJC Scopus subject areas

  • Surgery

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