Low frequency of bacteremia after endoscopic mucosal resection

Lee, Tzong-Hsi; Hsueh, Po-Ren; Yeh, Wei‐Ting; Wang, Hsiu‐Po; Wang, Teh‐Hong; Lin, Jaw‐Town

doi:10.1067/mge.2000.107718

Cited by 37 publications

(24 citation statements)

References 17 publications

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“…However, there has been no study on the frequency of bacteremia in patients with LC undergoing ESD. In addition, several studies reported the low rate of bacteremia after EMR or ESD 26,27. Blood culture results were negative in both patients with fever in the present study.…”

Section: Discussionsupporting

confidence: 55%

The Feasibility and Safety of the Endoscopic Submucosal Dissection of Superfi cial Gastric Neoplastic Lesions in Patients with Compensated Liver Cirrhosis: A Retrospective Study

Choi¹,

Kim²,

Min³

et al. 2012

Gut Liver

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Background/AimsWhen undergoing endoscopic submucosal dissection (ESD), patients with liver cirrhosis (LC) may suffer from a high risk of bleeding, bacteremia and tissue vulnerability. There have been few reports evaluating the efficacy and safety of ESD in patients with LC.MethodsFrom January 2004 to March 2010, 23 patients with LC (cirrhosis group) underwent ESD for superficial gastric neoplastic lesions. The number of patients with a liver function in the Child-Pugh classes A and B were 20 and 3, respectively. The clinical outcomes and complications were compared with 69 patients without LC (control group) that were matched for age and sex.ResultsThe en bloc resection, R0 resection and en bloc plus R0 resection rates of the cirrhosis group were 82.6%, 91.3%, and 82.6%, respectively, and did not show significant differences from the rates of the control group. No local recurrence was found in either group during the follow-up period. The procedure length of time (41.0 vs 39.0 minutes), rate of bleeding (4.3% vs 7.2%) and rate of perforation (0.0% vs 1.4%) in the cirrhosis group were also comparable to the results from the control group.ConclusionsESD was safely performed in patients with LC, and satisfactory outcomes were achieved with high en bloc and R0 resection rates for superficial gastric neoplastic lesions.

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Section: Discussionsupporting

confidence: 55%

The Feasibility and Safety of the Endoscopic Submucosal Dissection of Superfi cial Gastric Neoplastic Lesions in Patients with Compensated Liver Cirrhosis: A Retrospective Study

Choi¹,

Kim²,

Min³

et al. 2012

Gut Liver

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“…However, in the present study, we have demonstrated that gastric ESD induced a 2.0% rate of bacteremia, with no clinically manifest infection. The low rate of bacteremia associated with gastric ESD is comparable to the rate associated with conventional EMR for gastric neoplasias [22]. Min et al [23] have also demonstrated that colonic EMR, or even colonic ESD (small numbers of 10 ESD cases) is considered a low-risk procedure for bacteremia.…”

Section: Discussionmentioning

confidence: 74%

Bacteremia and endotoxemia after endoscopic submucosal dissection for gastric neoplasia: pilot study

et al. 2011

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Background Because the invasive procedure of endoscopic submucosal dissection (ESD) entails a large mucosal defect which is left open, with extensive submucosal exposure to the indigenous bacterial flora, the procedure may have a substantial risk for bacteremia. Our aim was to examine gastric ESD-related bacteremia and endotoxemia in gastric neoplasia patients. Methods In patients who underwent ESD for superficial gastric neoplasia, blood cultures and plasma endotoxin measurements were done before, immediately after, and on day 2 after ESD. Clinically manifest infections and inflammatory markers, including C-reactive protein (CRP) and white blood cells, were monitored. Results Fifty patients (aged 69 ± 8 years; mean ± SD) were enrolled. The diameter of the resected specimens was 38 ± 18 mm and the procedure time of ESD was 66 ± 53 min. Two percent (2/100) of blood cultures after ESD were positive, with findings as follows:Propionibacterium species immediately after ESD, and Enterobacter aerogenes on day 2 after ESD, but no clinically manifest infection was observed. In 30% of the enrolled patients, CRP on day 2 after ESD had increased to levels higher than 1.0 mg/l. Plasma endotoxin levels, immediately after and on day 2 after ESD were correlated with CRP levels on day 2 after ESD. Conclusions In spite of the invasive procedure with massive submucosal exposure to the indigenous bacterial flora, gastric ESD has a low risk for bacteremia. Gastric ESD-related endotoxemia may be linked to inflammatory reactions such as those shown by the increase of CRP or fever observed after ESD.

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“…They are observed in 30%-40% of the cases of infectious endocarditis (39) , but are also responsible for transient bacteremias, i.e., those that do not result in infection. These bacteria are observed after endoscopic procedures such as EGD (5,31,46,51) , esophageal dilation (51) , endoscopic retrograde cholangiopancreatography (ERCP), endoscopic mucosal resection (23) , EVS (12,40,46,50,52) and EVL (24) . The explanation for bacteremia would be that, as the endoscope moves along the oropharynx it can injure the mucosa, thus favoring bacteremia (12,46) .…”

Section: Discussionmentioning

confidence: 99%

Bacteremia in cirrhotic patients submitted to endoscopic band ligation of esophageal varices

Maulaz

Mattos

Pereira-Lima

et al. 2003

Arq. Gastroenterol.

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-Background -Endoscopic procedures can develop bacteremia. Patients with chronic liver disease are more predisposed to undergo bacteremia and infections because they are immunocompromised. Aims -The purpose of this study was to determine the incidence of bacteremia in cirrhotics submitted to endoscopic variceal ligation. Methods -Three groups of 40 patients each were studied. One group was made up of patients with cirrhosis who were submitted to ligation, a second group was composed of cirrhotics who underwent esophagogastroduodenoscopy only, and a third group was composed of patients without liver disease who underwent esophagogastroduodenoscopy. Blood was sampled from all patients for culture, both in aerobic and in anaerobic mediums, immediately before endoscopy and at 5 and 30 minutes after its completion. Results -Blood culture was positive in 6 samples. In 4 of these, the bacteria (Staphylococcus hominis hominis, Staphylococcus auricularis, Acinetobacter lwoffii, and coagulase-negative staphylococcus) were isolated before the endoscopic procedure and thus were considered as contamination. In the ligation group, a streptococcus of the viridans group was isolated 5 minutes after the procedure, and in the cirrhosis without ligation group, a Staphylococcus epidermidis was isolated at 30 minutes. None of the patients showed clinical evidence of infection. Conclusions -The bacteremia incidence in cirrhotic patients submitted to variceal ligation was 2.5%, showing no difference from the control groups.

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Low frequency of bacteremia after endoscopic mucosal resection

Cited by 37 publications

References 17 publications

The Feasibility and Safety of the Endoscopic Submucosal Dissection of Superfi cial Gastric Neoplastic Lesions in Patients with Compensated Liver Cirrhosis: A Retrospective Study

The Feasibility and Safety of the Endoscopic Submucosal Dissection of Superfi cial Gastric Neoplastic Lesions in Patients with Compensated Liver Cirrhosis: A Retrospective Study

Bacteremia and endotoxemia after endoscopic submucosal dissection for gastric neoplasia: pilot study

Bacteremia in cirrhotic patients submitted to endoscopic band ligation of esophageal varices

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