Predictive Factors for Pain After Endoscopic Resection of Gastric Tumors

Abstract

Background Abdominal pain is a common complaint following endoscopic resection (ER).

Aims To investigate the predictive factors for abdominal pain after ER.

Methods Patients who were scheduled to undergo endoscopic mucosal resection or endoscopic submucosal dissection for the treatment of gastric adenoma or cancer were prospectively enrolled. Pain scores were checked every 6 h after ER and whenever patients complained of pain by using a 0–10 pain scale. If the pain score exceeded 5, 25 mg of intravenous (IV) pethidine was administered.

Results Among 156 patients who underwent ER, 66 (42.3 %) received IV pethidine due to moderate/severe abdominal pain. Both the number of patients complaining of abdominal pain and the pain scores decreased with time following the procedure, with only a few patients complaining of mild abdominal pain 2 days after ER. Multivariate analysis showed that female sex [odds ratio (OR) 2.88; confidence interval (CI) 1.31–6.33], tumor location in the lower third of the stomach (OR 5.46; CI 2.31–12.92), and procedures time more than 60 min (OR 2.96; CI 1.26–6.98) were significant predictive factors for developing pain after ER.

Conclusions Female sex, tumor location in the lower third of the stomach, and longer procedure time were significantly associated with pain after ER. Close monitoring and active management of pain is recommended for patients who have these risk factors. With these efforts, the majority of patients could experience pain relief within 2 days after the procedure.