Endoscopy 2013; 45(09): 714-717
DOI: 10.1055/s-0033-1344555
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Risk of electrocoagulation syndrome after endoscopic submucosal dissection in the colon and rectum

Dahyun Jung
1  Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
,
Young Hoon Youn
1  Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
,
Jaehoon Jahng
2  Yongin Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
,
Jie-Hyun Kim
1  Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
,
Hyojin Park
1  Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
› Author Affiliations
Further Information

Publication History

submitted 08 October 2012

accepted after revision 12 June 2013

Publication Date:
29 August 2013 (online)

Background and study aims: The risk of post endoscopic submucosal dissection electrocoagulation syndrome (PEECS) is unknown. We aimed to investigate the incidence and clinicopathologic risk factors associated with PEECS after colorectal endoscopic submucosal dissection (ESD).

Patients and methods: All patients treated with colorectal ESD between 2009 and 2011 by a single expert ESD endoscopist at Gangnam Severance Hospital, Seoul, Korea were included in this retrospective study. Patients who had fever, regional rebound tenderness, or marked leukocytosis after ESD were defined as having PEECS. 

Results: 89 patients were treated during the study period. Six patients with microperforation and one patient with overt perforation were excluded. Thus, 82 cases without perforation were analyzed. The risk of PEECS was 40.2 %. In the PEECS group, the mean size of resected specimens was larger and mean procedure time was longer than in the patients without PEECS. The risk of PEECS was significantly lower for patients with carcinoid tumors, and for ESD in the rectosigmoid area. Piecemeal resection was significantly associated with the development of PEECS. In multivariate analysis, lesion size larger than 3 cm (odds ratio [OR] 5.0, 95 % confidence interval [95 %CI] 1.2 – 21.7) and site other than rectosigmoid (OR 7.6, 95 %CI 2.1 – 27.9) were independent risk factors for PEECS. 

Conclusions: Large tumor size and tumor site other than rectosigmoid were independent risk factors related to PEECS. Patients with tumors larger than 3 cm, in colon areas other than the rectosigmoid, should be observed carefully after colorectal ESD.