Although perforation is one of major complications of ESD, there has been little prospective study on the clinical outcomes of this condition. We evaluated clinical outcomes and risk factors for endoscopic perforation during ESD in a prospective study. Methods: We prospectively investigated 98 consecutive gastric neoplasms

undergoing ESD regarding the clinical outcomes and risk factors for the development of perforation. In a subgroup analysis, we also compared the clinical outcomes between perforation and “silent” free air without endoscopically visible perforation detected only by computed tomography. Results: Perforation was identified in 8.2% of patients. All patients were managed conservatively by the administration of antibiotics. The mean procedure time was significantly longer in patients with endoscopic selleck chemicals perforation than in those without. According to the receiver-operating characteristic analysis, the resulting cutoff value of the procedure time for perforation was 115 minutes (87.5% sensitivity, 56.7% specificity). Prolonged procedure time (≥115 min)

was associated with an increased risk of perforation (odds ratio 9.15; 95% confidence interval, 1.08–77.54; p = 0.04). Following ESD, the body temperature and C-reactive protein level were selleck chemicals llc significantly higher in patients with perforation than in those without (p = 0.02), whereas there was no difference between these patient groups on the starting day of oral intake or of hospitalization. In subgroup analysis, the post-ESD clinical course was not different between endoscopic perforation and silent free air. Conclusion: Prolonged procedure time (≥115 min), but not tumor location, was significantly Bumetanide associated with perforation. The clinical outcomes of perforation are favorable and are comparable to those of patients with or without silent free air. Key Word(s): 1. gastric cancer; 2. endoscopic treatment; 3. perforation; 4. risk factors; Presenting Author: RAVINDRALUXMAN SATARASINGHE Additional Authors: JAYEWARDENE RATHNAYAKE, SATHYAJITH ANBAWATTE, NAYOMISHERMILA JAYASINGHE, RAVI WIJESINGHE, PUBUDU DE SILVA,

NARTHANI RESEND RAN Corresponding Author: RAVINDRALUXMAN SATARASINGHE, NAYOMISHERMILA JAYASINGHE Affiliations: Sri Jayewardenepura Hospital Objective: To study the major indications for upper gastrointestinal endoscopy in a cohort of adult Sri Lankans presented to a tertiary care center over a decade. Methods: Case notes of 2728 patients who had undergone upper gastrointestinal endoscopy in the principle authors unit at Sri Jayewardenepura General Hospital, Kotte, Sri Lanka from 15th of February 2002 to 15th February 2013 were retrospectively analyzed to obtain the required information. Results: The age range of endoscoped patients was 11 years to 95 years of age with a mean age of 54.1 with ± 16.2 of SD years.