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Intraoperative Gastroscopy for Tumor Localization in Laparoscopic Surgery for Gastric Adenocarcinoma

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Endoscopic sleeve gastroplasty reintervention score using supervised machine learning.

Hassam Ali¹, Pratik Patel², Talia Farrukh Malik³

¹Department of Internal Medicine, East Carolina University/Brody School of Medicine, Greenville, North Carolina, USA.

Gastrointestinal Endoscopy

|June 1, 2023

Summary

This summary is machine-generated.

A new Endoscopic Sleeve Gastroplasty Reintervention Score (ESG-RS) helps predict early reintervention risk after ESG. This score identifies patients needing closer monitoring for adverse events, improving procedural safety.

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Area of Science:

Bariatric Surgery
Gastroenterology
Medical Informatics

Background:

Reintervention after Endoscopic Sleeve Gastroplasty (ESG) is sometimes necessary due to complications or comorbidities.
A validated tool is needed to predict the risk of early reintervention after ESG.

Purpose of the Study:

To develop and validate an Endoscopic Sleeve Gastroplasty Reintervention Score (ESG-RS) for predicting 30-day reintervention risk.
To identify key predictors of reintervention following ESG.

Main Methods:

Utilized data from 3583 patients who underwent ESG (2016-2021) from a quality improvement database.
Employed LASSO regression to select predictors, followed by multivariate analysis to create the ESG-RS.
Assessed model performance using 10-fold cross-validation and receiver-operator curves.

Main Results:

Identified 5 key predictors for the ESG-RS: prior foregut surgery, preoperative anticoagulation, female gender, ASA class ≥II, and hypertension.
The ESG-RS demonstrated good predictive ability with an Area Under the Curve of 0.74.
An optimal cutpoint of 67.9 was established, differentiating high-risk from low-risk patients with 76% sensitivity and 71% specificity.

Conclusions:

The developed ESG-RS provides a valuable tool for preoperative risk stratification in patients undergoing ESG.
Clinicians can use the ESG-RS to identify patients at higher risk for early reintervention, enabling proactive management.