Features of electrocoagulation syndrome after endoscopic submucosal dissection for colorectal neoplasm

Takeshi Yamashina, Yoji Takeuchi, Noriya Uedo, Kenta Hamada, Kenji Aoi, Yasushi Yamasaki, Noriko Matsuura, Takashi Kanesaka, Tomofumi Akasaka, Sachiko Yamamoto, Noboru Hanaoka, Koji Higashino, Ryu Ishihara, Hiroyasu Iishi

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Abstract

BACKGROUND AND AIMS: Endoscopic submucosal dissection (ESD) is a promising treatment for large gastrointestinal superficial neoplasms, although it is technically difficult, and perforation and delayed bleeding are well-known adverse events. However, there have been no large studies about electrocoagulation syndrome after colorectal ESD. The aim of this study was to evaluate the incidence and clinical significant risk factors of post-ESD coagulation syndrome (PECS).

METHODS: This was a retrospective cohort study conducted in a referral cancer center. A total of 336 patients with colorectal neoplasms (143 adenomas or serrated lesions and 193 carcinomas) underwent ESD from January 2011 to June 2013. Incidence, outcome, and factors associated with occurrence of PECS were investigated.

RESULTS: Occurred in 32 patients (9.5%). The median time until PECS was 15.5 h, and the median period of PECS was 32.5 h. Fever (≥37.6 °C) after ESD was found in 41% of the PECS group and 9% of the non-PECS group (P < 0.001). All PECS cases were managed conservatively. On multivariate analysis, female patients (odds ratio [OR] = 3.2, P = 0.002), lesion location at ascending colon and cecum (OR = 3.5, P = 0.001), and resected specimen ≥40 mm (OR = 2.1, P = 0.05) were independent risk factors for PECS.

CONCLUSIONS: Occurred in 32 patients (9.5%) with colorectal ESD; however, all cases had a good outcome with conservative management. Female sex, tumor location at the ascending colon and cecum, and resected specimen ≥40 mm were independently significant risk factors for PECS.

Original languageEnglish
Pages (from-to)615-20
Number of pages6
JournalJournal of Gastroenterology and Hepatology
Volume31
Issue number3
DOIs
Publication statusPublished - Mar 2016
Externally publishedYes

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Keywords

  • Adenoma/surgery
  • Carcinoma/surgery
  • Cecum
  • Cohort Studies
  • Colon, Ascending
  • Colonoscopy/adverse effects
  • Colorectal Neoplasms/surgery
  • Dissection/adverse effects
  • Electrocoagulation/adverse effects
  • Female
  • Humans
  • Incidence
  • Male
  • Multivariate Analysis
  • Postoperative Complications/epidemiology
  • Retrospective Studies
  • Risk Factors
  • Sex Factors
  • Syndrome
  • Time Factors
  • Treatment Outcome

Cite this

Yamashina, T., Takeuchi, Y., Uedo, N., Hamada, K., Aoi, K., Yamasaki, Y., Matsuura, N., Kanesaka, T., Akasaka, T., Yamamoto, S., Hanaoka, N., Higashino, K., Ishihara, R., & Iishi, H. (2016). Features of electrocoagulation syndrome after endoscopic submucosal dissection for colorectal neoplasm. Journal of Gastroenterology and Hepatology, 31(3), 615-20. https://doi.org/10.1111/jgh.13052