Endoscopic and Clinical Factors Affecting the Prognosis of Colorectal Endoscopic Submucosal Dissection-Related Perforation

Background/Aims: Although colorectal endoscopic submucosal dissection (ESD)-related perforation is not uncommon, the factors affecting clinical outcomes after perforation have not been investigated. This study was designed to investigate the factors influencing the clinical course of ESD-related col...

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Bibliographic Details
Published in:Gut and liver 2016-03, Vol.10 (3), p.420
Main Authors: Dong Uk Kang, Yunsik Choi, Ho Su Lee, Hyo Jeong Lee, Sang Hyoung Park, Dong Hoon Yang, Soon Man Yoon, Kyung Jo Kim, Byong Duk Ye, Seung Jae Myung, Suk Kyun Yang, Jin Ho Kim, Jeong Sik Byeon
Format: Article
Language:Korean
Subjects:
Colon
Endoscopic submucosal dissection
Out-come
Perforation
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Summary:Background/Aims: Although colorectal endoscopic submucosal dissection (ESD)-related perforation is not uncommon, the factors affecting clinical outcomes after perforation have not been investigated. This study was designed to investigate the factors influencing the clinical course of ESD-related colon perforation. Methods: Forty-three patients with colorectal ESD-related perforation were evaluated. The perforations were classified as endoscopic or radiologic perforations. The patients’ medical records and endoscopic pictures were analyzed. Results: The clinical outcomes were assessed by the duration of nil per os, intravenous antibiotics administration, and hospital stays, which were 2.7±1.5, 4.9±2.3, and 5.1±2.3 days, respectively. Multivariate analyses revealed that a larger tumor size, ESD failure, specific endoscopists, and abdominal pain were independently related to a poorer outcome. The time between perforation and clipping was 15.8±25.4 minutes in the endoscopic perforation group. The multivariate analysis of this group indicated that delayed clipping, specific endoscopists, and abdominal pain were independently associated with poorer outcomes. Conclusions: Tumor size, ESD failure, abdominal pain, and the endoscopist were factors that affected the clinical outcomes of patients with colorectal ESD-related perforation. The time between the perforation and clipping was an additional factor influencing the clinical course of endoscopic perforation. Decreasing this time period may improve outcomes. (Gut Liver 2016;10:420-428)
ISSN:1976-2283
2005-1212