High Joule heat as a risk factor for post-endoscopic submucosal dissection electrocoagulation syndrome:A multicenter prospective study  

作　　者：Masanori Ochi Asaji Yamamoto Satoshi Suematsu Keita Fukuda Kenjiro Morishige Yasuhiro Oka Yuta Ishikawa Shunsuke Ueyama Yoshinori Hiroshima Yoshio Omae Fumihiko Kusano Toshiro Kamoshida 

机构地区：[1]Department of Gastroenterology,Hitachi General Hospital,Ibaraki 317-0077,Japan [2]Department of Gastroenterology,Institute of Medicine,University of Tsukuba,Tsukuba 305-8576,Japan [3]Department of Gastroenterology,Shoujukai Medical Association,Kiyosumi-Shirakawa Family Clinic,Tokyo 135-0021,Japan [4]Hitachi Society Cooperation Education Research Center,University of Tsukuba,Hitachi 317-0077,Japan [5]Department of Gastroenterology,Ome Medical Center,Tokyo 198-0042,Japan [6]Department of Gastroenterology,Tsuchiura Kyodo General Hospital,Ibaraki 300-0028,Japan [7]Department of Gastroenterology,Kawasaki Saiwai Hospital,Kanagawa 212-0014,Japan [8]Department of Gastroenterology,Tokyo Metropolitan Cancer and Infectious Diseases Center,Tokyo 113-8677,Japan [9]Department of Gastroenterology,Hitachinaka General Hospital,Ibaraki 312-0057,Japan

出　　处：《World Journal of Gastrointestinal Endoscopy》2024年第12期668-677,共10页世界胃肠内镜杂志（英文）

摘　　要：BACKGROUND Thermal damage may lead to inflammation of the peeled mucosal surface during endoscopic submucosal dissection(ESD).AIM To determine the effect of Joule heat on the onset of post-ESD electrocoagulation syndrome(PECS).METHODS In this prospective study,PECS was characterized by in-hospital fever(white blood cell count:≥10000μ/L or body temperature≥37.5℃)and abdominal pain(visual analog scale score≥30 mm during hospitalization or increased by≥20 mm from baseline at admission).High Joule heat was defined as 15390 J.Between April 2020 and April 2024,209 patients underwent colorectal ESD;those with intraoperative perforation or penetration were excluded.The remaining 202 patients were divided into the PECS and non-PECS groups.RESULTS PECS occurred in 30(14.9%)patients.Multivariate analysis revealed high Joule heat as an independent factor associated with PECS(odds ratio=7.96;95%confidence interval:2.91-21.8,P<0.01).The procedure time and presence of lesions in the right colon were not associated with PECS.CONCLUSION Accumulated thermal damage on the peeled mucosal surface should be considered during PECS onset.This thermal damage is likely a major component of the mechanism underlying PECS.

关 键 词：Colorectal tumors Colorectal endoscopic submucosal dissection Joule heat Post-endoscopic submucosal dissection electrocoagulation syndrome Thermal damage 

分 类 号：R735.34[医药卫生—肿瘤]