Risk factors of electrocoagulation syndrome after esophageal endoscopic submucosal dissection

Dae Won Ma, Young Hoon Youn, Da Hyun Jung, Jae Jun Park, Jie-Hyun Kim, HyoJin Park

Research output: Contribution to journalArticle

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Abstract

AIM: To investigate post endoscopic submucosal dissection electrocoagulation syndrome (PEECS) of the esophagus. METHODS: We analyzed 55 consecutive cases with esophageal endoscopic submucosal dissection for superficial esophageal squamous neoplasms at a tertiary referral hospital in South Korea. Esophageal PEECS was defined as "mild" meeting one of the following criteria without any obvious perforation: fever (≥ 37.8°C), leukocytosis (> 10800 cells/μl), or regional chest pain more than 5/10 points as rated on a numeric pain intensity scale. The grade of PEECS was determined as "severe" when meet two or more of above criteria. RESULTS: We included 51 cases without obvious complications in the analysis. The incidence of mild and severe esophageal PEECS was 47.1% and 17.6%, respectively. Risk factor analysis revealed that resected area, procedure time, and muscle layer exposure were significantly associated with PEECS. In multivariate analysis, a resected area larger than 6.0 cm2 (OR = 4.995, 95%CI: 1.110-22.489, P = 0.036) and muscle layer exposure (OR = 5.661, 95%CI: 1.422-22.534, P = 0.014) were independent predictors of esophageal PEECS. All patients with PEECS had favorable outcomes with conservative management approaches, such as intravenous hydration or antibiotics. CONCLUSION: Clinicians should consider the possibility of esophageal PEECS when the resected area exceeds 6.0 cm2 or when the muscle layer exposure is noted.

Original languageEnglish
Pages (from-to)1144-1151
Number of pages8
JournalWorld Journal of Gastroenterology
Volume24
Issue number10
DOIs
Publication statusPublished - 2018 Mar 14

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Electrocoagulation
Muscles
Republic of Korea
Leukocytosis
Esophageal Neoplasms
Chest Pain
Tertiary Care Centers
Esophagus
Statistical Factor Analysis
Fever
Multivariate Analysis
Anti-Bacterial Agents
Pain
Incidence
Endoscopic Mucosal Resection

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

Ma, Dae Won ; Youn, Young Hoon ; Jung, Da Hyun ; Park, Jae Jun ; Kim, Jie-Hyun ; Park, HyoJin. / Risk factors of electrocoagulation syndrome after esophageal endoscopic submucosal dissection. In: World Journal of Gastroenterology. 2018 ; Vol. 24, No. 10. pp. 1144-1151.
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abstract = "AIM: To investigate post endoscopic submucosal dissection electrocoagulation syndrome (PEECS) of the esophagus. METHODS: We analyzed 55 consecutive cases with esophageal endoscopic submucosal dissection for superficial esophageal squamous neoplasms at a tertiary referral hospital in South Korea. Esophageal PEECS was defined as {"}mild{"} meeting one of the following criteria without any obvious perforation: fever (≥ 37.8°C), leukocytosis (> 10800 cells/μl), or regional chest pain more than 5/10 points as rated on a numeric pain intensity scale. The grade of PEECS was determined as {"}severe{"} when meet two or more of above criteria. RESULTS: We included 51 cases without obvious complications in the analysis. The incidence of mild and severe esophageal PEECS was 47.1{\%} and 17.6{\%}, respectively. Risk factor analysis revealed that resected area, procedure time, and muscle layer exposure were significantly associated with PEECS. In multivariate analysis, a resected area larger than 6.0 cm2 (OR = 4.995, 95{\%}CI: 1.110-22.489, P = 0.036) and muscle layer exposure (OR = 5.661, 95{\%}CI: 1.422-22.534, P = 0.014) were independent predictors of esophageal PEECS. All patients with PEECS had favorable outcomes with conservative management approaches, such as intravenous hydration or antibiotics. CONCLUSION: Clinicians should consider the possibility of esophageal PEECS when the resected area exceeds 6.0 cm2 or when the muscle layer exposure is noted.",
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Risk factors of electrocoagulation syndrome after esophageal endoscopic submucosal dissection. / Ma, Dae Won; Youn, Young Hoon; Jung, Da Hyun; Park, Jae Jun; Kim, Jie-Hyun; Park, HyoJin.

In: World Journal of Gastroenterology, Vol. 24, No. 10, 14.03.2018, p. 1144-1151.

Research output: Contribution to journalArticle

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T1 - Risk factors of electrocoagulation syndrome after esophageal endoscopic submucosal dissection

AU - Ma, Dae Won

AU - Youn, Young Hoon

AU - Jung, Da Hyun

AU - Park, Jae Jun

AU - Kim, Jie-Hyun

AU - Park, HyoJin

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N2 - AIM: To investigate post endoscopic submucosal dissection electrocoagulation syndrome (PEECS) of the esophagus. METHODS: We analyzed 55 consecutive cases with esophageal endoscopic submucosal dissection for superficial esophageal squamous neoplasms at a tertiary referral hospital in South Korea. Esophageal PEECS was defined as "mild" meeting one of the following criteria without any obvious perforation: fever (≥ 37.8°C), leukocytosis (> 10800 cells/μl), or regional chest pain more than 5/10 points as rated on a numeric pain intensity scale. The grade of PEECS was determined as "severe" when meet two or more of above criteria. RESULTS: We included 51 cases without obvious complications in the analysis. The incidence of mild and severe esophageal PEECS was 47.1% and 17.6%, respectively. Risk factor analysis revealed that resected area, procedure time, and muscle layer exposure were significantly associated with PEECS. In multivariate analysis, a resected area larger than 6.0 cm2 (OR = 4.995, 95%CI: 1.110-22.489, P = 0.036) and muscle layer exposure (OR = 5.661, 95%CI: 1.422-22.534, P = 0.014) were independent predictors of esophageal PEECS. All patients with PEECS had favorable outcomes with conservative management approaches, such as intravenous hydration or antibiotics. CONCLUSION: Clinicians should consider the possibility of esophageal PEECS when the resected area exceeds 6.0 cm2 or when the muscle layer exposure is noted.

AB - AIM: To investigate post endoscopic submucosal dissection electrocoagulation syndrome (PEECS) of the esophagus. METHODS: We analyzed 55 consecutive cases with esophageal endoscopic submucosal dissection for superficial esophageal squamous neoplasms at a tertiary referral hospital in South Korea. Esophageal PEECS was defined as "mild" meeting one of the following criteria without any obvious perforation: fever (≥ 37.8°C), leukocytosis (> 10800 cells/μl), or regional chest pain more than 5/10 points as rated on a numeric pain intensity scale. The grade of PEECS was determined as "severe" when meet two or more of above criteria. RESULTS: We included 51 cases without obvious complications in the analysis. The incidence of mild and severe esophageal PEECS was 47.1% and 17.6%, respectively. Risk factor analysis revealed that resected area, procedure time, and muscle layer exposure were significantly associated with PEECS. In multivariate analysis, a resected area larger than 6.0 cm2 (OR = 4.995, 95%CI: 1.110-22.489, P = 0.036) and muscle layer exposure (OR = 5.661, 95%CI: 1.422-22.534, P = 0.014) were independent predictors of esophageal PEECS. All patients with PEECS had favorable outcomes with conservative management approaches, such as intravenous hydration or antibiotics. CONCLUSION: Clinicians should consider the possibility of esophageal PEECS when the resected area exceeds 6.0 cm2 or when the muscle layer exposure is noted.

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