Factors predictive of perforation during endoscopic submucosal dissection for the treatment of colorectal tumors

Kim, E. S.; Cho, K. B.; Park, K. S.; Lee, KiWon; Jang, Byoung Kuk; Chung, Woo Jin; Hwang, Jang‐Sun

doi:10.1055/s-0030-1256339

Cited by 161 publications

(132 citation statements)

References 13 publications

(15 reference statements)

Supporting

Mentioning

117

Contrasting

Unclassified

Order By: Relevance

Section: Discussionsupporting

confidence: 90%

“…A study reported that submucosal fibrosis, long procedure time, tumor size, tumor location of a flexure, and an inexperienced operator were risk factors for complication (14)(15)(16). In our study, we looked at large tumors (>10 cm 2 ) and found that tumor size was technically demanding for perforation, which is consistent with what was observed in previous studies (14)(15)(16). However, a recent study found that when ESD were performed before 2010, tumor size might be technically demanding for perforation, but when ESD was performed after 2010 in the same institution, the results were different (11).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Predictive factors for technically difficult endoscopic submucosal dissection in large colorectal tumors

He¹,

Wang²,

Du³

et al. 2016

Turk J Gastroenterol

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Predictive factors for technically difficult endoscopic submucosal dissection in large colorectal tumors

He¹,

Wang²,

Du³

et al. 2016

Turk J Gastroenterol

View full text Add to dashboard Cite

“…Factors such as large tumor size, laterally spreading tumors, tumor location (right-sided colon), submucosal injection without hyaluronic acid, severe fibrosis, and deep-submucosally invasive cancer were associated with a higher rate of perforation in other studies [8,10,20,21] . On the other hand, poor endoscopic operability was also reported to be related with perforation [22] .…”

mentioning

confidence: 68%

“…Difficulties of ESD result in incomplete en bloc resection and perforation in colorectal ESD [6][7][8][9][10] . It is therefore important to predict difficult cases.…”

Section: Discussionmentioning

confidence: 99%

“…There are other factors attributed to this perceived difficulty. The location, size of the lesion, and degree of fibrosis has been previously identified as risk factors for incomplete resection and perforation of colorectal ESD [7][8][9][10] . Since these risk factors made ESD difficult to perform, only experts conducted the procedure in the early years.…”

Section: Difficult Manipulation Is One Of the Risk Factors For Incompmentioning

confidence: 99%

See 1 more Smart Citation

Difficult Manipulation is One of the Risk Factors for Incomplete Resection in Colorectal Endoscopic Submucosal Dissection

Yoshida

Fernandopulle

Murakami

et al. 2016

Journal of Gastroenterology and Hepatology Research

View full text Add to dashboard Cite

AIM:Colorectal endoscopic submucosal dissection (ESD) remains a difficult procedure, even for experts. Difficult manipulation during procedure is one of the most important problems in colorectal ESD. In this study, we analyzed the risk factors for incomplete resection in colorectal ESD, focusing on difficult manipulation. MATERIALS AND METHODS:We retrospectively analyzed 405 consecutive tumors for which ESD was performed at the Kyoto Prefectural University of Medicine from 2010 to 2013 by a single expert endoscopist with extensive ESD experiences. The relationship between incomplete resection and clinicopathological factors were examined. Additionally, multivariate analysis was performed to examine risk factors of difficult manipulation. RESULTS:The rate of incomplete resection was 3.2%. The rates of severe fibrosis, difficult manipulation, and perforation were 10.8%, 23.5%, and 2.7%, respectively. Multivariate analyses showed that severe fibrosis (OR: 26.395, 95% CI: 6.587-105.764, p < 0.

show abstract

Risk factors for perforation during colorectal endoscopic submucosal dissection

Yang

Hung

Chen

2022

Adv in Digestive Medicine

View full text Add to dashboard Cite

Endoscopic submucosal dissection (ESD) achieves higher en bloc resection rates than endoscopic mucosal resection in early colorectal neoplasms. However, perforation occurs more frequently during ESD. We aimed to identify the risk factors for perforation during colorectal ESD. A total of 161 patients treated with colorectal ESD at a tertiary center between January 2014 and December 2019 were enrolled in this retrospective study. Perforation was defined as a deep defect of the muscularis propria, with or without direct contact with connective tissue outside the colon. Clinical risk factors for perforation during ESD, including age, sex, tumor morphology, tumor size, tumor location, procedure time, en bloc resection rate, histology, and submucosal fibrosis, were analyzed. The mean size of the ESD specimens was 38.2 ± 24.6 mm. The overall en bloc resection rate was 98.1%. Perforations occurred during ESD in 31 out of 161 patients (19.3%). All perforations were successfully treated with endoscopic closure using the hemoclips and nonsurgical management. Emergency surgery was not required in our patients. On multivariate analysis, severe submucosal fibrosis (odds ratio [OR] 3.06; 95% confidence interval [CI] 1.23‐7.59; P = .016) and location in the right colon (OR 4.54; 95% CI 1.31‐15.79; P = .017) were independent risk factors. Perforation during colorectal ESD occurred in 31 patients (19.3%), but all patients had a good outcome without surgery. Submucosal fibrosis and its location are risk factors for perforation during ESD.

show abstract

Factors predictive of perforation during endoscopic submucosal dissection for the treatment of colorectal tumors

Abstract: Tumor size and fibrosis are important factors related to complications during colorectal ESD. Younger age and development of abdominal pain can predict the hospital course in patients with perforation after ESD.

Cited by 161 publications

References 13 publications

Predictive factors for technically difficult endoscopic submucosal dissection in large colorectal tumors

Predictive factors for technically difficult endoscopic submucosal dissection in large colorectal tumors

Difficult Manipulation is One of the Risk Factors for Incomplete Resection in Colorectal Endoscopic Submucosal Dissection

Risk factors for perforation during colorectal endoscopic submucosal dissection

Contact Info

Product

Resources

About