{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T22:14:29Z","timestamp":1787004869901,"version":"build-2736575974"},"reference-count":28,"publisher":"Georg Thieme Verlag KG","issue":"CP","license":[{"start":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T00:00:00Z","timestamp":1761523200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Evidence on gastric endoscopic submucosal dissection (ESD) under glucocorticoids or immunomodulators (GC\/IM) is limited. We evaluated whether GC\/IM use affects gastric ESD outcomes.<\/jats:p>\n                  <jats:p>We retrospectively analyzed 411 consecutive ESDs (April 2017-April 2022). GC\/IM users (n = 32) were compared with controls (n = 379); 1:3 propensity-score matching yielded 27 vs 81 patients. The primary outcome was overall complications, defined as a composite of pain, fever, delayed bleeding, and delayed perforation. Secondary outcomes were each component, intra-procedure perforation, hospital stay, and use of symptom-directed treatments (analgesics, antipyretics, antibiotics).<\/jats:p>\n                  <jats:p>Overall complications were more frequent with GC\/IM than controls (44.4% vs 21.0%; P = 0.024; relative risk [RR] 2.11, 95% confidence interval 1.16\u20133.84), driven by pain (40.7% vs 18.5%; P = 0.035) and fever (11.1% vs 1.2%; P = 0.047). Rates of major complications did not differ (delayed bleeding 3.7% vs 2.5%; delayed perforation 0% vs 0%). Intra-procedure perforation was numerically higher (7.4% vs 3.7%) without significance. Median (interquartile range) hospital stay showed a small, non-significant difference (9 [7\u201312] vs 8 [7\u20139] days; P = 0.064). Symptom management was used more often with GC\/IM (analgesics 25.9% vs 3.7%, P = 0.002; antipyretics 7.4% vs 2.5%, P = 0.270; antibiotics 7.4% vs 3.7%, P = 0.597).<\/jats:p>\n                  <jats:p>In patients receiving GC\/IM, gastric ESD was associated with a higher incidence of minor, clinically managed events\u2014chiefly pain and transient fever\u2014whereas major complications remained uncommon. With close monitoring and prompt symptom-directed care, gastric ESD appeared clinically feasible, albeit with slightly greater resource use and observation time.<\/jats:p>","DOI":"10.1055\/a-2733-1229","type":"journal-article","created":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T23:48:02Z","timestamp":1761608882000},"source":"Crossref","is-referenced-by-count":2,"special_numbering":"S","title":["Clinical feasibility of gastric endoscopic submucosal dissection in patients on glucocorticoids or immunomodulators: Propensity-score-matched study"],"prefix":"10.1055","volume":"13","author":[{"given":"Hiroki","family":"Fukuya","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, National Hospital Organisation Kyushu Medical Center, Fukuoka, Japan"},{"name":"Institute of Research Center, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eikichi","family":"Ihara","sequence":"additional","affiliation":[{"name":"Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoichiro","family":"Iboshi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, National Hospital Organisation Kyushu Medical Center, Fukuoka, Japan"},{"name":"Institute of Research Center, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yorinobu","family":"Sumida","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Kitakyushu Municipal Medical Center, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisuke","family":"Yoshimura","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, National Hospital Organisation Kyushu Medical Center, Fukuoka, Japan"},{"name":"Institute of Research Center, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shohei","family":"Hamada","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, National Hospital Organisation Kyushu Medical Center, Fukuoka, Japan"},{"name":"Institute of Research Center, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taisuke","family":"Sasaki","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, National Hospital Organisation Kyushu Medical Center, Fukuoka, Japan"},{"name":"Institute of Research Center, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akito","family":"Ohkubo","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, National Hospital Organisation Kyushu Medical Center, Fukuoka, Japan"},{"name":"Institute of Research Center, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuichi","family":"Itonaga","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, National Hospital Organisation Kyushu Medical Center, Fukuoka, Japan"},{"name":"Institute of Research Center, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitoshi","family":"Homma","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, National Hospital Organisation Kyushu Medical Center, Fukuoka, Japan"},{"name":"Institute of Research Center, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryota","family":"Okitsu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, National Hospital Organisation Kyushu Medical Center, Fukuoka, Japan"},{"name":"Institute of Research Center, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihisa","family":"Ohno","sequence":"additional","affiliation":[{"name":"Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7353-2153","authenticated-orcid":false,"given":"Mitsuru","family":"Esaki","sequence":"additional","affiliation":[{"name":"Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naohiko","family":"Harada","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, National Hospital Organisation Kyushu Medical Center, Fukuoka, Japan"},{"name":"Institute of Research Center, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,11,11]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1111\/den.13883","article-title":"Guidelines for endoscopic submucosal dissection and endoscopic mucosal resection for early gastric cancer (second edition)","volume":"33","author":"H Ono","year":"2021","journal-title":"Dig Endosc"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"170","DOI":"10.5946\/ce.2016.017","article-title":"Comparison of endoscopic submucosal dissection and surgery for differentiated type early gastric 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