Original Articles
The incidence of electrocoagulation syndrome after endoscopic submucosal dissection in the colorectal laterally spreading tumors and the risk factors
Xiang Liu, Mi Gao, Sheng Wang, Nan Ge, Guoxin Wang, Jintao Guo, Siyu Sun
Published 2015-03-20
Cite as Chin J Dig Endosc, 2015, 32(3): 149-153. DOI: 10.3760/cma.j.issn.1007-5232.2015.03.004
Abstract
ObjectiveTo investigate the incidence of electrocoagulation syndrome after endoscopic submucosal dissection(ESD) in the colorectal laterally spreading tumors(LST) and the risk factors.
MethodsData of 51 patients with coloretral LST, treated with ESD from January 2010 to May 2014 at Shengjing hospital affiliated to China Medical University, were reviewed. The incidence of electrocoagulation syndrome was analyzed and logistic regression was used to evaluate risk.
ResultsThe incidence of electrocoagulation syndrome was 9.8%(5/51). The incidence of tumors in the rectal area(7.1%, 2/28) was lower than that of the left half colon (12.5%, 1/8), and the right colon (13.3%, 2/15). Multivariable logistic regression analysis showed that the independent risk factors for the development of electrocoagulation syndrome were LST located in non-rectum area (OR=1.655, P<1.655), lesion size larger than 25 mm (OR=1.028, P<0.05), the operation time longer than 129 min (OR=1.016, P<0.05), age older than 62 year old (OR=0.987, P<0.05).
ConclusionFor the patients aged over 62 year old, lesion size larger than 25 mm, the operation time longer than 129 min and LST located outside the rectum, the mucous membrane should be separated from the muscularis propria in the ESD procedure to reduce electrocoagulation time as much as possible. In the postoperative period, patients need fasting, fluid replacement support, and prevention of post endoscopic submucosal dissection electrocoagulation syndrome (PEECS).
Key words:
Incidence; Risk factors; Laterally spreading tumor(LST); Endoscopic submucosal dissection(ESD); Electrocoagulation syndrome
Contributor Information
Xiang Liu
Endoscopy Center, Shengjing Hospital of China Medical Univercity, Shenyang 110000, China
Mi Gao
Sheng Wang
Nan Ge
Guoxin Wang
Jintao Guo
Siyu Sun