Nomogram to predict gas-related complications during transoral endoscopic resection of upper gastrointestinal submucosal lesions

BACKGROUND Gas-related complications present a potential risk during transoral endoscopic resection of upper gastrointestinal submucosal lesions.Therefore,the identification of risk factors associated with these complications is essential.AIM To develop a nomogram to predict risk of gas-related complications following transoral endoscopic resection of the upper gastrointestinal submucosal lesions.METHODS We collected patient data from the First Affiliated Hospital of the Army Medical University.Patients were randomly allocated to training and validation cohorts.Risk factors for gas-related complications were identified in the training cohort using univariate and multivariate analyses.We then constructed a nomogram and evaluated its predictive performance based on the area under the curve,decision curve analysis,and Hosmer-Lemeshow tests.RESULTS Gas-related complications developed in 39 of 353 patients who underwent transoral endoscopy at our institution.Diabetes,lesion origin,surgical resection method,and surgical duration were incorporated into the final nomogram.The predictive capability of the nomogram was excellent,with area under the curve values of 0.841 and 0.906 for the training and validation cohorts,respectively.CONCLUSION The ability of our four-variable nomogram to efficiently predict gas-related complications during transoral endoscopic resection enhanced postoperative assessments and surgical outcomes.