Evidence map›Paper›PMID 33852062›Full record

ArticleSurgical endoscopy2022

The risk scoring system for assessing the technical difficulty of endoscopic submucosal dissection in cases of remnant gastric cancer after distal gastrectomy.

Shinwa Tanaka, Tetsuya Yoshizaki, Yoshinobu Yamamoto, Takayuki Ose, Tsukasa Ishida, Yasuaki Kitamura, Daisuke Obata, Mineo Iwatate, Mikio Fujita, Atsushi Ikeda and 10 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
1.6field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 13 citations in OpenAlex.

  1. Clinical outcomes of endoscopic resection for remnant gastric cancer: a multicenter prospective cohort study.Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors at 11 institutions in 1 country.

Shinwa TanakaDivision of Gastroenterology, Department of Internal Medicine, Graduate School of Medicine, Kobe University, 7-5-1 Chu-o-ku, Kusunoki-Cho, Kobe, Hyogo, 650-0017, Japan. tanakas@med.kobe-u.ac.jp.
Tetsuya YoshizakiDepartment of Gastroenterology, Saiseikai Nakatsu Hospital, Osaka, Japan.
Yoshinobu YamamotoDepartment of Gastroenterology, Hyogo Cancer Center, Akashi, Japan.
Takayuki OseDepartment of Gastroenterology, Kita-Harima Medical Center, Ono, Japan.
Tsukasa IshidaDepartment of Gastroenterology, Akashi Medical Center, Akashi, Japan.
Yasuaki KitamuraDepartment of Gastroenterology, Yodogawa Christian Hospital, Osaka, Japan.
Daisuke ObataDepartment of Gastroenterology, Kobe Red Cross Hospital, Kobe, Japan.
Mineo IwatateDepartment of Gastroenterology, Sano Hospital, Kobe, Japan.
Mikio FujitaDepartment of Gastroenterology, Sano Hospital, Kobe, Japan.
Atsushi IkedaDepartment of Gastroenterology, Sanda City Hospital, Sanda, Japan.
Ryusuke AriyoshiDepartment of Gastroenterology, Steel Memorial Hirohata Hospital, Himeji, Japan.
Fumiaki KawaraDepartment of Gastroenterology, Konan Medical Center, Kobe, Japan.
Hirofumi AbeDivision of Gastroenterology, Department of Internal Medicine, Graduate School of Medicine, Kobe University, 7-5-1 Chu-o-ku, Kusunoki-Cho, Kobe, Hyogo, 650-0017, Japan.
Toshitatsu TakaoDivision of Gastroenterology, Department of Internal Medicine, Graduate School of Medicine, Kobe University, 7-5-1 Chu-o-ku, Kusunoki-Cho, Kobe, Hyogo, 650-0017, Japan.
Yoshinori MoritaDivision of Gastroenterology, Department of Internal Medicine, Graduate School of Medicine, Kobe University, 7-5-1 Chu-o-ku, Kusunoki-Cho, Kobe, Hyogo, 650-0017, Japan.
Yasushi SanoDepartment of Gastroenterology, Sano Hospital, Kobe, Japan.
Eiji UmegakiDivision of Gastroenterology, Kawasaki Medical School, Kurashiki, Japan.
Hogara NishisakiDepartment of Internal Medicine, Hyogo Prefectural Tamba Medical Center, Tamba, Japan.
Takashi ToyonagaDivision of Gastroenterology, Department of Internal Medicine, Graduate School of Medicine, Kobe University, 7-5-1 Chu-o-ku, Kusunoki-Cho, Kobe, Hyogo, 650-0017, Japan.
Yuzo KodamaDivision of Gastroenterology, Department of Internal Medicine, Graduate School of Medicine, Kobe University, 7-5-1 Chu-o-ku, Kusunoki-Cho, Kobe, Hyogo, 650-0017, Japan.
Kobe University · JPAkashi Medical Center · JPHyogo Prefectural Cancer Center · JPJapanese Red Cross Kobe Hospital · JPKawasaki Medical School · JPNippon Steel Yawata Memorial Hospital · JPSaiseikai Nakatsu Hospital · JPSanden (Japan) · JPTokyo-Kita Medical Center · JPTokyo Metropolitan Tama-Hokubu Medical Center · JPYodogawa Christian Hospital · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEndoscopic submucosal dissection (ESD) for remnant gastric cancer (RGC) after distal gastrectomy (DG) is considered technically challenging due to the narrow working space, and severe fibrosis and staples from the previous surgery. Technical difficulties of ESD for RGC after DG have not been thoroughly investigated. This study aimed to develop and validate a risk-scoring system for assessing the technical difficulty of ESD for RGC after DG in a large multicenter cohort.

methodsWe investigated patients who underwent ESD for RGC after DG in 10 institutions between April 2008 and March 2018. A difficult case was defined as ESD lasting ≥ 120 min, involving piecemeal resection, or the occurrence of perforation during the procedure. A risk-scoring system for the technical difficulty of the procedure was developed based on multiple logistic regression analyses, and its performance was internally validated using bootstrapping.

resultsA total of 197 consecutive patients with 201 lesions were analyzed. There were 90 and 111 difficult and non-difficult cases, respectively. The scoring model consisted of four independent risk factors and points of risk scores were assigned for each as follows: tumor size > 20 mm: 2 points; anastomosis site: 2 points; suture line: 1 point; and non-expert endoscopist: 2 points. The C-statistics of the scoring system for technical difficulty was 0.72.

conclusionsWe developed a validated risk-scoring model for predicting the technical difficulty of ESD for RGC after DG that can contribute to its safer and more reliable performance.

Indexed as

Endoscopic Mucosal ResectionStomach NeoplasmsGastrectomyGastric MucosaHumansRetrospective StudiesRisk FactorsTreatment OutcomeDistal gastrectomyEndoscopic submucosal dissectionGastric cancerRemnant stomachRisk-scoring systemTechnical difficulty

Identifiers

PMID33852062
OpenAlexW3152589698

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.