{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T16:25:12Z","timestamp":1754151912535,"version":"3.41.2"},"reference-count":7,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,5,10]],"date-time":"2024-05-10T00:00:00Z","timestamp":1715299200000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["JGH Open"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>Although no specific sedation recommendations exist in early\u2010stage gastric cancer (ESGC) for endoscopic submucosal dissection (ESD), dexmedetomidine (DEX) is useful along with benzodiazepines and analgesics. Furthermore, DEX is used for endoscopic treatment requiring lengthy sedation. However, it is unclear which patients should be administered DEX. We examined the factors that determine when DEX should be added for sedation during ESD for ESGC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Of 316 patients undergoing ESD for ESGC at our hospital between January 2017 and December 2020, we examined 310 receiving intravenous anesthesia. Preoperative patient factors and treatment outcomes were retrospectively examined according to the sedation method.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among patients with ESGC undergoing ESD at our hospital, DEX was more frequently used alongside sedation in men, those undergoing gastrectomy, those with a lesion diameter \u226520\u2009mm, and those with preoperative ulcers. In the standard group, patients whose treatment duration exceeded 120\u2009min typically had a lesion diameter \u226520\u2009mm, preoperative ulcers, lesions located outside the L region, and were treated by junior physicians.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>It is important to evaluate specific preoperative factors (lesion diameter \u226520\u2009mm, preoperative ulcers, lesion located outside the L region, and having a junior physician as the treating physician) in patients undergoing ESD for ESGC to determine whether the combined use of DEX in sedation is necessary.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jgh3.13065","type":"journal-article","created":{"date-parts":[[2024,5,10]],"date-time":"2024-05-10T03:00:24Z","timestamp":1715310024000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Determining factors for dexmedetomidine sedation in endoscopic submucosal dissection for early\u2010stage gastric cancer"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-8895-3406","authenticated-orcid":false,"given":"Erika","family":"Yoshida","sequence":"first","affiliation":[{"name":"Division of Gastroenterology Showa University Fujigaoka Hospital  Yokohama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yorimasa","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Internal Medicine Hitachi Zosen Health Insurance Union, Innoshima General Hospital  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Misako","family":"Tohata","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Showa University Fujigaoka Hospital  Yokohama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8914-1170","authenticated-orcid":false,"given":"Kuniyo","family":"Gomi","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Showa University Fujigaoka Hospital  Yokohama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tadashi","family":"Okayasu","sequence":"additional","affiliation":[{"name":"Anesthesiology Showa University Fujigaoka Hospital  Yokohama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masatsugu","family":"Nagahama","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Showa University Fujigaoka Hospital  Yokohama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,5,10]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"2322","article-title":"Risk factors associated with aspiration Pneumonia during the perioperative period following esd for gastric tumor","volume":"63","author":"Akiko S","year":"2021","journal-title":"Gastroenterol. Endosc."},{"key":"e_1_2_7_3_1","first-page":"30","article-title":"Short\u2010term outcomes of multicenter prospective cohort study of gastric endoscopic resection: real\u2010world evidence in Japan","volume":"31","author":"Haruhisa S","year":"2019","journal-title":"Gastroenterol. Endosc."},{"key":"e_1_2_7_4_1","first-page":"1637","article-title":"Guidelines for sedation in gastroenterological endoscopy (second edition)","volume":"62","author":"Gotoda T","year":"2020","journal-title":"Gastroenterol. Endosc."},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.12399"},{"key":"e_1_2_7_6_1","first-page":"56","article-title":"Treatment outcomes of endoscopic submucosal dissection for early gastric cancer with ulceration findings","volume":"48","author":"Noboru K","year":"2013","journal-title":"Stomach Intest."},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1746.2008.05675.x"},{"key":"e_1_2_7_8_1","first-page":"477","article-title":"Endoscopic injection sclerotherapy under red dichromatic imaging for esophageal varices","volume":"34","author":"Takuto H","year":"2022","journal-title":"Gastroenterol. Endosc."}],"container-title":["JGH Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jgh3.13065","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T09:14:26Z","timestamp":1753089266000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jgh3.13065"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5]]},"references-count":7,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,5]]}},"alternative-id":["10.1002\/jgh3.13065"],"URL":"https:\/\/doi.org\/10.1002\/jgh3.13065","archive":["Portico"],"relation":{},"ISSN":["2397-9070","2397-9070"],"issn-type":[{"type":"print","value":"2397-9070"},{"type":"electronic","value":"2397-9070"}],"subject":[],"published":{"date-parts":[[2024,5]]},"assertion":[{"value":"2024-02-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-05-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e13065"}}