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

Wei Chen1, Xiao-Nan Zhu1, Jin Wang1

  • 1Department of Gastroenterology and Hepatology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China.

World Journal of Gastroenterology
|September 28, 2019
PubMed
Abstract

Insights

Mallory-Weiss Tears (MWT) occurred in 5.4% of patients undergoing esophageal endoscopic submucosal dissection (ESD). Female sex and longer procedure times are key risk factors for MWT during ESD.

Area of Science:

  • Gastroenterology
  • Gastrointestinal Endoscopy
  • Surgical Complications

Background:

  • Adverse events like perforation and bleeding are known complications of endoscopic submucosal dissection (ESD) for superficial esophageal neoplasms.
  • The occurrence and risk factors of Mallory-Weiss Tears (MWTs) during esophageal ESD are not well-established.

Purpose of the Study:

  • To determine the incidence of MWTs during esophageal ESD.
  • To identify clinicopathological risk factors associated with MWT development during esophageal ESD.

Main Methods:

  • Retrospective analysis of 337 patients with superficial esophageal neoplasms who underwent ESD between June 2014 and July 2017.
  • Patients were categorized into MWT and non-MWT groups to compare incidence and explore risk factors.
  • Multivariate analysis was employed to identify independent risk factors for MWT.

Main Results:

  • The incidence of MWTs during esophageal ESD was 5.4% (20 out of 337 patients).
  • Independent risk factors for MWT included female sex (OR=5.36) and procedure time exceeding 88.5 minutes (OR=3.95).
  • Most MWTs were managed conservatively with endoscopic hemostasis, and all patients recovered without surgery.

Conclusions:

  • The incidence of MWTs during esophageal ESD is higher than previously thought.
  • While typically benign, MWTs can lead to severe complications, necessitating careful monitoring.
  • Routine inspection of the stomach during and after ESD is recommended for early detection and management of MWTs.
Keywords:
Endoscopic submucosal dissectionIncidenceMallory-Weiss TearRisk factorsSuperficial esophageal neoplasms

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