Academic Journal
Prospective multicenter validation of a clinical score model for muscular injury risk stratification during esophageal endoscopic submucosal dissection.
| Title: | Prospective multicenter validation of a clinical score model for muscular injury risk stratification during esophageal endoscopic submucosal dissection. |
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| Authors: | Geng ZH; Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, 180 FengLin Road, Shanghai, 200032, People's Republic of China.; Shanghai Collaborative Innovation Center of Endoscopy, Shanghai, China., Lyu P; Zhongshan Hospital (Xiamen), Fudan University, Xiamen, China., Yao L; Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, 180 FengLin Road, Shanghai, 200032, People's Republic of China.; Shanghai Collaborative Innovation Center of Endoscopy, Shanghai, China., Qu YF; Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, 180 FengLin Road, Shanghai, 200032, People's Republic of China.; Shanghai Collaborative Innovation Center of Endoscopy, Shanghai, China., Zhu Y; Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, 180 FengLin Road, Shanghai, 200032, People's Republic of China.; Shanghai Collaborative Innovation Center of Endoscopy, Shanghai, China., Fu PY; Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, 180 FengLin Road, Shanghai, 200032, People's Republic of China.; Shanghai Collaborative Innovation Center of Endoscopy, Shanghai, China., Chen WF; Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, 180 FengLin Road, Shanghai, 200032, People's Republic of China.; Shanghai Collaborative Innovation Center of Endoscopy, Shanghai, China., Zhou PH; Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, 180 FengLin Road, Shanghai, 200032, People's Republic of China. zhou.pinghong@zs-hospital.sh.cn.; Shanghai Collaborative Innovation Center of Endoscopy, Shanghai, China. zhou.pinghong@zs-hospital.sh.cn., Li QL; Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, 180 FengLin Road, Shanghai, 200032, People's Republic of China. li.quanlin@zs-hospital.sh.cn.; Shanghai Collaborative Innovation Center of Endoscopy, Shanghai, China. li.quanlin@zs-hospital.sh.cn., Liu ZQ; Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, 180 FengLin Road, Shanghai, 200032, People's Republic of China. liu.zuqiang@zs-hospital.sh.cn.; Shanghai Collaborative Innovation Center of Endoscopy, Shanghai, China. liu.zuqiang@zs-hospital.sh.cn. |
| Source: | Surgical endoscopy [Surg Endosc] 2026 Oct; Vol. 40 (10), pp. 8785-8789. Date of Electronic Publication: 2026 Jul 28. |
| Publication Type: | Journal Article; Multicenter Study; Validation Study |
| Language: | English |
| Journal Info: | Publisher: Springer Country of Publication: Germany NLM ID: 8806653 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-2218 (Electronic) Linking ISSN: 09302794 NLM ISO Abbreviation: Surg Endosc Subsets: MEDLINE |
| Imprint Name(s): | Publication: 1992- : New York : Springer Original Publication: [Berlin] : Springer International, c1987- |
| MeSH Terms: | Endoscopic Mucosal Resection*/adverse effects , Esophageal Neoplasms*/surgery , Intraoperative Complications*/etiology , Muscle, Smooth*/injuries , Esophagoscopy*/adverse effects , Esophagus*/injuries, Risk Assessment/methods ; Humans ; Prospective Studies ; Male ; Female ; Aged ; Middle Aged |
| Abstract: | Background and Aims: A clinical score model has been developed to stratify the risk of muscular injury during esophageal endoscopic submucosal dissection (ESD). This study aimed to prospectively validate the model in a multicenter cohort. Methods: A multicenter prospective cohort analysis of esophageal ESD was conducted. Individual data on patients, lesions, and outcomes of ESD were utilized to validate the model for muscular injury risk stratification. Results: A total of 704 patients with esophageal lesions treated by ESD across two hospitals were included in the study. Muscular injury occurred in 10.5% of low-risk and 61.5% of high-risk patients. The scoring system demonstrated good discriminatory performance, with an AUC of 0.761 (95% CI 0.713-0.809). Conclusions: The clinical score model showed acceptable performance for muscular injury risk stratification during esophageal ESD and may support perioperative decision-making. (© 2026. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.) |
| Competing Interests: | Declarations. Disclosures: Drs. Zi-Han Geng, Peng Lyu, Lu Yao, Yi-Fan Qu, Yan Zhu, Pei-Yao Fu, Wei-Feng Chen, Ping-Hong Zhou, Quan-Lin Li, and Zu-Qiang Liu have no conflicts of interest or financial ties to disclose. |
| References: | Gastrointest Endosc. 2010 Apr;71(4):715-21. (PMID: 20363414) Surg Endosc. 2020 Sep;34(9):4065-4071. (PMID: 31953729) Gastrointest Endosc. 2023 Oct;98(4):534-542.e7. (PMID: 37207844) Endoscopy. 2009 Aug;41(8):661-5. (PMID: 19565442) Dig Endosc. 2009 Jul;21 Suppl 1:S4-6. (PMID: 19691732) |
| Grant Information: | 82170555 National Natural Science Foundation of China; 82270569 National Natural Science Foundation of China; 82200600 National Natural Science Foundation of China; 22XD1422400 Shanghai Academic/Technology Research Leader; 22SG06 Shuguang Program of Shanghai Education Development Foundation and Shanghai Municipal Education Commission; 20224Z0005 Shanghai Rising Stars of Medical Talent Youth Development Program; 2023M740675 the 74th General Support of China Postdoctoral Science Foundation |
| Contributed Indexing: | Keywords: Clinical score model; Endoscopic submucosal dissection (ESD); Muscular injury; Prospective validation; Risk stratification |
| Entry Date(s): | Date Created: 20260728 Date Completed: 20261002 Latest Revision: 20261008 |
| Update Code: | 20261008 |
| DOI: | 10.1007/s00464-026-13065-0 |
| PMID: | 42521829 |
| Database: | MEDLINE |
| ISSN: | 1432-2218 |
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| DOI: | 10.1007/s00464-026-13065-0 |