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

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9 Citations (Scopus)


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°C), leukocytosis (> 10800 cells/μl), 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 cm2 (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 cm2 or when the muscle layer exposure is noted.

Original languageEnglish
Pages (from-to)1144-1151
Number of pages8
JournalWorld Journal of Gastroenterology
Issue number10
Publication statusPublished - 2018 Mar 14

Bibliographical note

Funding Information:
Supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science and ICT, No. NRF-2015R1C1A1A01054352.

Publisher Copyright:
© The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.

All Science Journal Classification (ASJC) codes

  • Gastroenterology


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