A Risk Score For Delayed Bleeding After Colorectal ESD From A Cohort Of More Than 500 Procedures

Aims ESD allows en bloc resection rates of over 90 %, thus allowing recurrence rates ranging from 1.3 to 3 %.

Delayed bleeding is, along with perforation, one of the most frequent adverse effects with rates ranging from 0.5 to 9.5 % according to the literature.

Methods This is a prospective single-center cohort study of all colorectal ESD conducted in a university hospital center for neoplastic epithelial lesions.

In order to identify the factors causing delayed bleeding, we compared the group with delayed bleeding and the group without bleeding according to the patient, lesion and procedure characteristics.

Results Between February 2013 and May 2020, 543 colorectal ESDs (312 colonic and 231 rectal) were performed with a greater mean diameter of 59 mm for a mean procedure duration of 92.95 mm. Delayed bleeding occurred in 39 patients (7.18 %).

In multivariate analysis, the risk factors for bleeding were size > 50 mm (OR: 7.85; confidence interval 2.367- 26.047; p=0.001), age > 75 years (OR: 2.76, confidence interval 1.375-5.569; p=0.004) and anticoagulant or antiaggregant use (OR: 1.87; confidence interval 0.920-3.809; p=0.084).

These 3 factors were included in a bleeding risk score with a weighting according to the Odds Ratio.

A score less than or equal to 3 (low risk) is associated with a delayed bleeding risk of 3.5 %, while a score of 4 (middle risk) or 5 (high risk) is associated with a risk of 11.6 % and 28.8 % respectively (p<0.05).

Conclusions In a cohort of 543 colorectal ESDs, the main risk factors for delayed bleeding are height > 50mm, age > 75 years and anti-aggregation or anticoagulant treatment. Our score established using these risk factors allows us to evaluate low-risk and high-risk procedures

Citation: Albouys J, Legros R, Dahan M et al. OP207 A RISK SCORE FOR DELAYED BLEEDING AFTER COLORECTAL ESD FROM A COHORT OF MORE THAN 500 PROCEDURES. Endoscopy 2021; 53: S86.

Publication History

Article published online:
19 March 2021