Endoscopy 2020; 52(S 01): S61-S62
DOI: 10.1055/s-0040-1704192
ESGE Days 2020 oral presentations
Thursday, April 23, 2020 16:30 – 18:00 Unlock en-bloc 2 Wicklow Hall 1
© Georg Thieme Verlag KG Stuttgart · New York

PREVALENCE OF INTRAPROCEDURAL AND DELAYED PERFORATION IN COLORECTAL ENDOSCOPIC SUBMUCOSAL DISSECTION. RESULTS OF A MULTICENTER SERIES

D de Frutos
1   Puerta de Hierro University Hospital, Gastroenterology Department, Endoscopy Unit, Majadahonda, Spain
2   IDIPHISA-Research Institute Segovia Arana, Majadahonda, Spain
,
J Santiago
1   Puerta de Hierro University Hospital, Gastroenterology Department, Endoscopy Unit, Majadahonda, Spain
2   IDIPHISA-Research Institute Segovia Arana, Majadahonda, Spain
,
B Agudo
1   Puerta de Hierro University Hospital, Gastroenterology Department, Endoscopy Unit, Majadahonda, Spain
2   IDIPHISA-Research Institute Segovia Arana, Majadahonda, Spain
,
L de la Corte
1   Puerta de Hierro University Hospital, Gastroenterology Department, Endoscopy Unit, Majadahonda, Spain
,
B Conde
1   Puerta de Hierro University Hospital, Gastroenterology Department, Endoscopy Unit, Majadahonda, Spain
,
P García
1   Puerta de Hierro University Hospital, Gastroenterology Department, Endoscopy Unit, Majadahonda, Spain
,
M Hernández
1   Puerta de Hierro University Hospital, Gastroenterology Department, Endoscopy Unit, Majadahonda, Spain
2   IDIPHISA-Research Institute Segovia Arana, Majadahonda, Spain
,
M López
1   Puerta de Hierro University Hospital, Gastroenterology Department, Endoscopy Unit, Majadahonda, Spain
2   IDIPHISA-Research Institute Segovia Arana, Majadahonda, Spain
,
MG Haba
1   Puerta de Hierro University Hospital, Gastroenterology Department, Endoscopy Unit, Majadahonda, Spain
2   IDIPHISA-Research Institute Segovia Arana, Majadahonda, Spain
3   MD Anderson Cancer Center-Hospiten, Gastroenterology and Hepatology Department, Madrid, Spain
,
AH de Tejada
1   Puerta de Hierro University Hospital, Gastroenterology Department, Endoscopy Unit, Majadahonda, Spain
3   MD Anderson Cancer Center-Hospiten, Gastroenterology and Hepatology Department, Madrid, Spain
4   La Luz-Quiron Salud Hospital, Gastroenterology and Hepatology Department, Madrid, Spain
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

Also available at
 

Aims To describe the prevalence of IP and DP and compare the consequences of both events.

Endoscopic perforation continues to be the most concerning complication associated with Colorectal Endoscopic Submucosal Dissection (CR-ESD). There are two main types: intraprocedural perforation (IP), diagnosed along or just after CR-ESD; delayed perforation (DP), presenting 8-72 hours after the CR-ESD.

Methods Data were based on a prospective registry of all the CR-ESD procedures performed by the same endoscopist (AH) or under his close supervision in three hospitals in Madrid. The first 50 cases were excluded to discard the effect of the learning curve.

Results Between January 2012 and July 2019, 277 CR-ESD cases were performed and analyzed. The prevalence of IP and DP was 27.8% and 1.4%, respectively (table 1). Endoscopic treatment was successful in 92% of the IP cases, with a median of 1 day of extra hospitalization. Only 6 cases of IP required surgical treatment. DP was mostly diagnosed within 24 hours after ESD, with 75% of the cases undergoing surgical treatment and a mean 7.5 days of extended hospital stay.

Tab. 1

Perforation in CR-ESD

Prevalence (%)

Extra Hospital Stay, days, Md (IQR)

Surgical treatment required (%)

Mortality

IP

77 (27.8)

1 (5)

6 (7.8)

0

DP

4 (1.4)

7.5 (7.5)

3 (75)

0

p value

<0.001

0.14

0.07

Conclusions IP in CR-ESD might be high in Wester centers, but endoscopic treatment seems successful in most of the cases, with a short addition of hospital stay. Although DP rate in CR-ESD is very low, it is associated with a high probability of surgical management and longer hospital stay.