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

Research output: Contribution to journalArticle

22 Citations (Scopus)

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

Fingerprint

Electrocoagulation
Colorectal Neoplasms
Ascending Colon
Cecum
Odds Ratio
Endoscopic Mucosal Resection
Gastrointestinal Neoplasms
Incidence
Adenoma
Neoplasms
Cohort Studies
Fever
Referral and Consultation
Multivariate Analysis
Retrospective Studies
Hemorrhage
Carcinoma

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

Features of electrocoagulation syndrome after endoscopic submucosal dissection for colorectal neoplasm. / Yamashina, Takeshi; Takeuchi, Yoji; Uedo, Noriya; Hamada, Kenta; Aoi, Kenji; Yamasaki, Yasushi; Matsuura, Noriko; Kanesaka, Takashi; Akasaka, Tomofumi; Yamamoto, Sachiko; Hanaoka, Noboru; Higashino, Koji; Ishihara, Ryu; Iishi, Hiroyasu.

In: Journal of Gastroenterology and Hepatology, Vol. 31, No. 3, 03.2016, p. 615-20.

Research output: Contribution to journalArticle

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, vol. 31, no. 3, pp. 615-20. https://doi.org/10.1111/jgh.13052
Yamashina, Takeshi ; Takeuchi, Yoji ; Uedo, Noriya ; Hamada, Kenta ; Aoi, Kenji ; Yamasaki, Yasushi ; Matsuura, Noriko ; Kanesaka, Takashi ; Akasaka, Tomofumi ; Yamamoto, Sachiko ; Hanaoka, Noboru ; Higashino, Koji ; Ishihara, Ryu ; Iishi, Hiroyasu. / Features of electrocoagulation syndrome after endoscopic submucosal dissection for colorectal neoplasm. In: Journal of Gastroenterology and Hepatology. 2016 ; Vol. 31, No. 3. pp. 615-20.
@article{a132ae4d4acf41ffbc4192ba59f871c6,
title = "Features of electrocoagulation syndrome after endoscopic submucosal dissection for colorectal neoplasm",
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.",
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",
author = "Takeshi Yamashina and Yoji Takeuchi and Noriya Uedo and Kenta Hamada and Kenji Aoi and Yasushi Yamasaki and Noriko Matsuura and Takashi Kanesaka and Tomofumi Akasaka and Sachiko Yamamoto and Noboru Hanaoka and Koji Higashino and Ryu Ishihara and Hiroyasu Iishi",
note = "{\circledC} 2015 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.",
year = "2016",
month = "3",
doi = "10.1111/jgh.13052",
language = "English",
volume = "31",
pages = "615--20",
journal = "Journal of Gastroenterology and Hepatology (Australia)",
issn = "0815-9319",
publisher = "Wiley-Blackwell",
number = "3",

}

TY - JOUR

T1 - Features of electrocoagulation syndrome after endoscopic submucosal dissection for colorectal neoplasm

AU - Yamashina, Takeshi

AU - Takeuchi, Yoji

AU - Uedo, Noriya

AU - Hamada, Kenta

AU - Aoi, Kenji

AU - Yamasaki, Yasushi

AU - Matsuura, Noriko

AU - Kanesaka, Takashi

AU - Akasaka, Tomofumi

AU - Yamamoto, Sachiko

AU - Hanaoka, Noboru

AU - Higashino, Koji

AU - Ishihara, Ryu

AU - Iishi, Hiroyasu

N1 - © 2015 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

PY - 2016/3

Y1 - 2016/3

N2 - 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.

AB - 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.

KW - Adenoma/surgery

KW - Carcinoma/surgery

KW - Cecum

KW - Cohort Studies

KW - Colon, Ascending

KW - Colonoscopy/adverse effects

KW - Colorectal Neoplasms/surgery

KW - Dissection/adverse effects

KW - Electrocoagulation/adverse effects

KW - Female

KW - Humans

KW - Incidence

KW - Male

KW - Multivariate Analysis

KW - Postoperative Complications/epidemiology

KW - Retrospective Studies

KW - Risk Factors

KW - Sex Factors

KW - Syndrome

KW - Time Factors

KW - Treatment Outcome

U2 - 10.1111/jgh.13052

DO - 10.1111/jgh.13052

M3 - Article

C2 - 26202127

VL - 31

SP - 615

EP - 620

JO - Journal of Gastroenterology and Hepatology (Australia)

JF - Journal of Gastroenterology and Hepatology (Australia)

SN - 0815-9319

IS - 3

ER -