In the literature titled ¿fever and electrocoagulation syndrome after colorectal endoscopic submucosal dissection for patients with immunosuppressants and steroids¿, patients experienced adverse effects during and after colorectal endoscopic submucosal dissection (esd) procedures using a single use electrosurgical knife (kd-655).
Study aim: assess the risk factors of post-esd fever and post-esd coagulation syndrome (pecs), focusing on the involvement of immunosuppressive drugs and steroids (im).
Methods: this retrospective analysis of 510 patients who underwent colorectal esd at a single facility over a five-year period.
The incidence rate, clinical outcome, and factors associated with post-esd fever and pecs were investigated.
Results: post-esd fever and pecs occurred in 63 patients (12.
4%) and 43 patients (8.
4%), respectively.
In multivariate analysis, the american society of anesthesiologists physical status >3, the use of immunosuppressants or prednisolone >5mg (im group), and injury to muscle layer/perforation were significantly associated with post-esd fever.
In pecs, im group, tumors located on the right side, treatment time >60 min, injury to the muscle layer, and multiple lesions were independent risk factors.
Both post-esd fever and pecs improved conservatively in the im group, and no serious complication was observed.
Conclusions: the use of im was a risk factor for both post-esd fever and pecs.
However, there were no serious complications in colorectal esd for patients taking im.
Summary of adverse events: a total of 30 (5.
9%) patients had muscle layer injuries.
Perforation occurred in 19 patients (3.
7%).
The complete closure of the mucosal defect was performed in 311 patients (61%).
Delayed perforation occurred in five patients (0.
9%).
Seventy-five patients (14.
7%) experienced abdominal pain 63 patients (12.
4%) experienced fever after esd.
Pecs occurred in 43 patients (8.
4%).
Three cases (two cases, delayed perforation; one case, perforation during the procedure) required emergency surgery after esd because of peritonitis that could not be improved by observation treatment.
There is no report of any olympus device malfunction in any procedure described in this study.
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