Endoscopic and Clinical Factors Affecting the Prognosis of Colorectal Endoscopic Submucosal Dissection-Related Perforation.
- Author:
Dong Uk KANG
1
;
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
Author Information
1. Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. jsbyeon@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Colon;
Endoscopic submucosal dissection;
Outcome;
Perforation
- MeSH:
Abdominal Pain;
Anti-Bacterial Agents;
Colon;
Humans;
Length of Stay;
Medical Records;
Multivariate Analysis;
Prognosis*
- From:Gut and Liver
2016;10(3):420-428
- CountryRepublic of Korea
- Language:English
-
Abstract:
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.
