{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T17:09:35Z","timestamp":1765040975354},"reference-count":122,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:sec>\n            <jats:title>Objective<\/jats:title>\n            <jats:p>Endoscopic submucosal dissection (ESD) is now established as the first option to manage early gastric neoplasms, but its efficacy may vary according to diverse factors. We aimed to systematically identify risk factors for poor <jats:italic toggle=\"yes\">short-term<\/jats:italic> outcomes of gastric ESD with the purpose to improve patients\u2019 selection and management.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Three online databases (<jats:italic toggle=\"yes\">MEDLINE<\/jats:italic>, <jats:italic toggle=\"yes\">ISI Web of Knowledge<\/jats:italic> and <jats:italic toggle=\"yes\">Scopus<\/jats:italic>) were searched (last search on June 2018) for poor outcomes of gastric ESD (deep submucosal invasion, piecemeal\/incomplete resection, noncurative resection and local recurrence).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>One hundred five studies were included referring to 52.126 ESDs. Undifferentiated histology and upper location (vs lower) were associated with submucosal invasion [odds ratio (OR) = 2.42 [95% confidence interval (CI), 1.62\u20133.61] and OR = 3.20 (1.04\u20139.86), respectively] and deep submucosal invasion [OR = 2.98 (2.02\u20134.39) and OR = 2.35 (1.45\u20133.81), respectively]. Lesion size greater than 30 mm and ulceration were associated with piecemeal resection [OR = 2.78 (1.17\u20136.60) and OR = 2.76 (1.23, 6.20), respectively]. Lesion size greater than 30 mm, ulceration, upper location and fibrosis were risk factors for incomplete resection [OR = 3.83 (2.68\u20135.49), OR = 4.06 (1.62\u201310.16), OR = 3.71 (2.49\u20135.54) and OR = 4.46 (1.66\u201311.96), respectively]. A noncurative resection was more often observed for lesions located in the upper third of the stomach [OR = 1.49 (1.24\u20131.79)], depressed morphology [OR = 1.49 (1.04\u20132.12)] and those outside standard criteria [OR = 3.56 (2.31\u20135.48)]. Older age was significantly linked with local recurrence rates [OR = 3.08 (1.13\u20135.02)].<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Several risk factors influence poor efficacy <jats:italic toggle=\"yes\">short-term<\/jats:italic> outcomes of gastric ESD that may be used to inform both patients and health providers about the expected efficacy.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/meg.0000000000001542","type":"journal-article","created":{"date-parts":[[2019,9,9]],"date-time":"2019-09-09T01:24:12Z","timestamp":1567992252000},"page":"1234-1246","source":"Crossref","is-referenced-by-count":13,"title":["Gastric endoscopic submucosal dissection: a systematic review and meta-analysis on risk factors for poor short-term outcomes"],"prefix":"10.1097","volume":"31","author":[{"given":"Gon\u00e7alo","family":"Figueir\u00f4a","sequence":"first","affiliation":[{"name":"MEDCIDS \u2013 Departamento de Medicina da Comunidade, Informa\u00e7\u00e3o e Decis\u00e3o em Sa\u00fade"}]},{"given":"Pedro","family":"Pimentel-Nunes","sequence":"additional","affiliation":[{"name":"MEDCIDS \u2013 Departamento de Medicina da Comunidade, Informa\u00e7\u00e3o e Decis\u00e3o em Sa\u00fade"},{"name":"Gastroenterology Department, Instituto Portugu\u00eas de Oncologia do Porto, Porto, Portugal"}]},{"given":"M\u00e1rio","family":"Dinis-Ribeiro","sequence":"additional","affiliation":[{"name":"MEDCIDS \u2013 Departamento de Medicina da Comunidade, Informa\u00e7\u00e3o e Decis\u00e3o em Sa\u00fade"},{"name":"Gastroenterology Department, Instituto Portugu\u00eas de Oncologia do Porto, Porto, Portugal"}]},{"given":"Diogo","family":"Lib\u00e2nio","sequence":"additional","affiliation":[{"name":"MEDCIDS \u2013 Departamento de Medicina da Comunidade, Informa\u00e7\u00e3o e Decis\u00e3o em Sa\u00fade"},{"name":"Gastroenterology Department, Instituto Portugu\u00eas de Oncologia do Porto, Porto, 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