Performance of perioperative antibiotics against post–endoscopic submucosal dissection coagulation syndrome: a multicenter randomized controlled trial

Shichijo, Satoki; Takeuchi, Yoji; Shimodate, Yuichi; Yamashina, Takeshi; Yamasaki, Tomoaki; Hayashi, Takemasa; Hirasawa, Kingo; Fukunaga, Shusei; Yamaguchi, Shinjiro; Asai, Satoshi; Kawamura, Takuji; Fukata, Norimasa; Yamamoto, Masashi; Teramoto, Akira; Kinjo, Yuzuru; Matsuno, Kenshi; Kinjo, Tetsu; Sano, Yasushi; Iwatsubo, Taro; Nagaike, Koji; Matsumoto, M; Hoki, Noriyuki; Kawamura, Ichiro; Shimokawa, Toshio; Ishikawa, Hideki; Tanaka, Kiyohito; Kitano, Masayuki

doi:10.1016/j.gie.2021.08.025

Gastrointestinal Endoscopy

2022

DOI: 10.1016/j.gie.2021.08.025

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Performance of perioperative antibiotics against post–endoscopic submucosal dissection coagulation syndrome: a multicenter randomized controlled trial

Satoki Shichijo

Yoji Takeuchi

Yuichi Shimodate

et al.

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Cited by 22 publications

(30 citation statements)

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“…Lesions located in the proximal colon are reportedly at high risk for PECS. 3,4 Thus, we closed the defect using clips with elastic rubber bands (Video S1). First, a clip (HX-610-090; Olympus, Tokyo, Japan) with an orthodontic rubber band fixed with a thread was attached to the normal mucosa at the anal side of the defect.…”

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confidence: 99%

Complete closure of a large mucosal defect using clips with an elastic rubber band after endoscopic submucosal dissection

Okubo

Shichijo

Takeuchi

2022

Digestive Endoscopy

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confidence: 99%

Complete closure of a large mucosal defect using clips with an elastic rubber band after endoscopic submucosal dissection

Okubo

Shichijo

Takeuchi

2022

Digestive Endoscopy

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“…5,6 However, the factors mentioned above had no significant effect on the occurrence of PECS in this study. 1 We wonder whether the authors could perform a subgroup analysis between a PECS group and a non-PECS group, regardless of whether or not the patients received perioperative antibiotics, to verify the effect of these factors on the overall incidence of PECS.…”

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confidence: 99%

“…Third, on the basis of a previous meta-analysis 7 and including this study, 1 we have conducted an updated metaanalysis of the association between prophylactic antibiotics and the incidence of PECS. In this analysis, the pooled odds ratio was 0.23 (P Z .003) (Fig.…”

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confidence: 99%

“…We thank Li et al 1 for their comments on our prospective randomized controlled trial (RCT) on perioperative antibiotics for postendoscopic submucosal dissection coagulation syndrome (PECS). 2 They commented on (1) the impact of excluded cases, (2) risk factors for PECS, and (3) updated meta-analysis about antibiotics and PECS.…”

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confidence: 99%

“…[4][5][6] Furthermore, we analyzed the effect of prophylactic antibiotics on all patients with perforation (n Z 22) and found no statistically significant difference between the clinical course of groups with or without antibiotics (Table 6 in the original article). 1 Therefore, we suppose that the results would not have changed even if we had enrolled patients with perforations.…”

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confidence: 99%

See 2 more Smart Citations

Prophylactic antibiotics for postendoscopic submucosal dissection coagulation syndrome

Fang

Liu

2022

Gastrointestinal Endoscopy

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Short‐term outcomes of patients undergoing endoscopic submucosal dissection for colorectal lesions

Nakajima

Nemoto

et al. 2022

DEN Open

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Objectives Endoscopic submucosal dissection (ESD) of colorectal lesions was invented in Japan, but postoperative management including hospital stay has not been reconsidered due to the Japanese insurance system. To explore appropriate postoperative management after colorectal ESD, we reviewed short‐term outcomes after ESD in non‐selected consecutive patients. Methods Patients who underwent colorectal ESD from April 2013 to September 2020 in one institution were reviewed. The primary outcome measure was the occurrence of adverse events stratified by the Clavien‐Dindo classification with five grades. A logistic regression model with the Firth procedure was applied to investigate predictors of severe (grade III or greater) adverse events. Results A total of 330 patients (female 40%, male 60%; median 72 years; IQR 65–80 years) with colorectal lesions (median 30 mm, IQR 23–40 mm; colon 77%, rectum 23%; serrated lesion 4%, adenoma 47%, mucosal cancer 30%, invasive cancer 18%) was evaluated. The en bloc resection rate was 97%. The median dissection time was 58 min (IQR: 38–86). Intraprocedural perforation occurred in 3%, all successfully treated by endoscopic clipping. No delayed perforations occurred. Postprocedural bleeding occurred in 3% on days 1–10 (median day 2); all were controlled endoscopically. Severe adverse events included only delayed bleeding. In analyzing severe adverse events in a multivariate logistic regression model with the Firth procedure, antithrombotic agent use ( p = 0.016) and rectal lesions ( p = 0.0010) were both significant predictors. Conclusions No serious adverse events occurred in this series. Four days of hospitalization may be too long for the majority of patients after ESD.

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Performance of perioperative antibiotics against post–endoscopic submucosal dissection coagulation syndrome: a multicenter randomized controlled trial

Cited by 22 publications

References 29 publications

Complete closure of a large mucosal defect using clips with an elastic rubber band after endoscopic submucosal dissection

Complete closure of a large mucosal defect using clips with an elastic rubber band after endoscopic submucosal dissection

Prophylactic antibiotics for postendoscopic submucosal dissection coagulation syndrome

Short‐term outcomes of patients undergoing endoscopic submucosal dissection for colorectal lesions

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