Background: Gastric endoscopic submucosal dissection (ESD) has a high rate of complications. However, it is unclear whether body mass index (BMI) affects ESD complications. We aimed to investigate the impact of BMI on ESD complications.
Methods: A total of 7263 patients who underwent gastric ESD were classified into three groups according to the Asia-Pacific classification of BMI: normal (BMI <23 kg/m2, n = 2466), overweight (BMI 23–24.9 kg/m2, n = 2117), and obese (BMI ≥25 kg/m2, n = 2680). Adjusted logistic regression analyses were conducted to assess the association between BMI and ESD complications.
Results: Compared to the normal group, a lower incidence of perforation and a higher incidence of pneumonia and leukocytosis were found in the overweight and obese groups, and intra-ESD desaturation and hypertension were more frequent in the obese group. After adjustment for confounders, the risk of perforation significantly decreased in the overweight (odds ratio [OR] = 0.24, 95% confidence interval [CI]: 0.17–0.33) and obese (OR = 0.12, 95% CI: 0.08–0.18) groups compared to that in the normal group. Meanwhile, the risk of pneumonia significantly increased in the overweight (OR = 11.04, 95% CI: 6.31–19.31) and obese (OR = 10.71, 95% CI: 6.14–18.66) groups compared to the normal group. During sedation, the obese group had a significantly increased risk of desaturation (OR = 2.81, 95% CI: 1.18–6.69) and hypertension (OR = 1.35, 95% CI: 1.11–1.63) compared to the normal group.
Conclusions: High BMI was significantly associated with ESD complications. More caution is needed in cases of obese patients undergoing ESD.
Impact of body mass index on complications of gastric endoscopic submucosal dissection