International Session(Workshop)3(JGES・JSGE・JSGS・JSGCS)
Sat. November 4th   14:00 - 16:30   Room 11: Portopia Hotel South Wing Topaz
Underwater endoscopic submucosal dissection for colorectal tumors decreases the incidence of post-electrocoagulation syndrome: a multicenter propensity score matching analysis
Yohei Koyama1, Masakatsu Fukuzawa1, Takao Itoi1
1Department of Gastroenterology and Hepatology, Tokyo Medical University Hospital
Background and Aims: Underwater endoscopic submucosal dissection (U-ESD) is a recently developed procedure that has the potential to prevent post-ESD coagulation syndrome (PECS) owing to its heat-sink effect. We aimed to clarify whether U-ESD decreases the incidence of PECS compared with conventional ESD (C-ESD).
Methods: A total of 205 patients who underwent colorectal ESD (C-ESD: 125; U-ESD: 80) were analyzed. Propensity score matching analysis was performed to adjust for patient backgrounds. The primary outcome was to compare the incidence of PECS between the U-ESD and C-ESD groups (54 matched pairs). The secondary outcomes were to compare procedural outcomes between the C-ESD and U-ESD groups (62 matched pairs).
Results: Among the 80 patients who underwent U-ESD, PECS occurred in only 1 patient (1.3%). Adjusted comparisons between the U-ESD and C-ESD groups demonstrated a significantly lower incidence of PECS in the U-ESD group (0% vs 11.1%; P = 0.027). Median dissection speed was significantly faster in the U-ESD than in the C-ESD group (10.9 mm2/min vs 6.9 mm2/min; P < 0.001). Although perforation and delayed bleeding occurred in 1 patient each (1.6%) in the U-ESD group, there were no differences compared with the C-ESD group.
Conclusions: Our study demonstrates that U-ESD effectively decreases the incidence of PECS, and is a faster and safer method for colorectal ESD.
Index Term 1: Endoscopic submucosal dissection
Index Term 2: post-electrocoagulation syndrome
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