POST-ENDOSCOPIC SUBMUCOSAL DISSECTION COAGULATION SYNDROME IN COLORECTAL LESIONS. INCIDENCE AND RISK FACTORS IN EUROPEAN POPULATION

Aims Primary: Descriptive analysis of Post-Endoscopic Submucosal Dissection Coagulation Syndrome (PECS) in a Spanish cohort of colorectal lesions.

Secondary: Associated risk factors (RF) analysis

Methods Consecutive prospective registry of all colorectal endoscopic submucosal dissection (CR-ESD) performed in 3 Spanish tertiary centres between January 2013 and August 2021. PECS was defined as abdominal pain and/or fever (>37ºC) after CR-ESD in absence of any infectious cause, intraprocedural or delayed perforation, and which induced an increase in hospital stay≥24 hours. The RF analysis was performed with univariate and multivariate logistic regression.

Results 492 CR-ESD were included. 47 cases of SPEC were registered (incidence 9.9% CI95 7.5-12.9) causing a median increase of hospital stay of 2 days (IQR 2). All cases responded to conservative medical treatment (fasting period extension, analgesia and broad-spectrum antibiotics) without need for rescue surgery.

A location proximal to the splenic flexure was the only RF for PECS that reached statistical significance in both uni and multivariable logistic regression analysis. The dissection speed was only significative as RF in the multivariable analysis.

Conclusions PECS presents as a common complication after CR-ESD in European population (up to 10%), however it is usually a mild event that will slightly increase the hospital stay.

Lesions located proximal to the splenic flexure present a 2-fold higher risk for PECS.

Dissection speed could be considered as a probable RF.

Publication History

Article published online:
14 April 2022