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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 
 WORLD JOURNAL OF GASTROENTEROLOGY, Vol.24(10) : 1144-1151, 2018 
Journal Title
Issue Date
Electrocoagulation ; Endoscopic submucosal dissection ; Esophageal neoplasm ; Syndrome
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 degrees C), leukocytosis (> 10800 cells/muL), 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 cm(2) (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 cm(2) or when the muscle layer exposure is noted.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jie-Hyun(김지현) ORCID logo https://orcid.org/0000-0002-9198-3326
Park, Jae Jun(박재준)
Park, Hyo Jin(박효진) ORCID logo https://orcid.org/0000-0003-4814-8330
Youn, Young Hoon(윤영훈) ORCID logo https://orcid.org/0000-0002-0071-229X
Jung, Da Hyun(정다현)
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