PROPHYLACTIC ANTIBIOTICS FOR PREVENTION OF ELECTROCOAGULATION SYNDROME AFTER COLONIC ENDOSCOPIC SUBMUCOSAL DISSECTION: DOES IT WORKS?

Aims:

Nowadays, endoscopic submucosal dissection (ESD) is performed widespread in the world even in colorectal superficial lesion treatment. Colonic ESD has some risk of adverse events like electrocoagulation (ECS) syndrome after performing ESD in that region. We aimed that to analyze whether the use of prophylactic antibiotics could be decrease the formation of ECS.

Methods:

This is a retrospective analysis of a prospective collected database including all patients who underwent colorectal ESD at Kocaeli University Gastroenterology Department, during the period from 2009 and 2015 for superficial lesions treatment including lateral spreading tumors. We evaluated the characteristics of the patients and tumors including whether given antibiotics, the incidence of ECS, acute phase reactans and the visual analog scale (VAS) score for abdominal pain measured before, four and 12 hours after ESD.

Results:

A total of 118 patients (M/F: 74/44) whom median age 58 (35 – 88) were included. All patients who has been reached successfully en bloc resection (n = 112) were evaluated. The incidence of ECS and proportion of the patients who having C-reactive protein (CRP) levels> 0.5 mg/dL were lower in patients who has given antibiotics than in those who has not (P = 0.04 and P = 0.05). Whereas, VAS scores difference was not statistically significant between both groups.

Conclusions:

The prophylactic use of ceftriaxone and metronidazole combination in colonic ESD is associated with decreased risk of ECS and lower CRP levels without significant reduced abdominal pain. The use of this combination seems to be as have an significant impact for decreasing the risk of ECS.

 

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