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Risk factors for procedure-related complications after endoscopic resection of colorectal laterally spreading tumors
Colorectal laterally spreading tumors (LSTs) are large and flat elevated neoplasms with diameters of at least 10 mm. Endoscopic resection of LSTs, with their large size and broad base, is difficult and dangerous compared with the resection of polypoid neoplasms. This study aimed to determine the ris...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6203567/ https://www.ncbi.nlm.nih.gov/pubmed/30313045 http://dx.doi.org/10.1097/MD.0000000000012589 |
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author | Hong, Ji-Yun Kweon, Sun-Seog Lee, Jun Kim, Sang-Wook Seo, Geom-Seog Kim, Hyun-Soo Joo, Young-Eun |
author_facet | Hong, Ji-Yun Kweon, Sun-Seog Lee, Jun Kim, Sang-Wook Seo, Geom-Seog Kim, Hyun-Soo Joo, Young-Eun |
author_sort | Hong, Ji-Yun |
collection | PubMed |
description | Colorectal laterally spreading tumors (LSTs) are large and flat elevated neoplasms with diameters of at least 10 mm. Endoscopic resection of LSTs, with their large size and broad base, is difficult and dangerous compared with the resection of polypoid neoplasms. This study aimed to determine the risk factors for procedure-related complications including bleeding and perforation after endoscopic resection of LSTs. Patients with colorectal LST undergoing endoscopic resection at 5 university hospitals in Honam Province of South Korea were enrolled, and their records about patients, lesions, and procedure parameters associated with the occurrence of complications were reviewed retrospectively. Logistic regression analysis was performed to identify risk factors for complications. The frequency of comorbidities in bleeding group was significantly higher than in the no bleeding group. The frequency of bleeding was significantly higher in lesions with adenocarcinoma than in lesions with low or high-grade dysplasia. The frequency of bleeding was significantly higher in piecemeal resection than in en bloc resection. The frequency of perforation was significantly higher in endoscopic mucosal resection-precutting (EMR-P) than in endoscopic mucosal resection (EMR) or endoscopic submucosal dissection. The mean procedure duration was significantly longer in the perforation group than in the no perforation group. On multivariate analysis, patient comorbidity and histologic grade of the lesion were significant independent risk factors for bleeding, whereas EMR-P was a significant independent risk factor for perforation after endoscopic resection. This study demonstrated that patient comorbidity and histologic grade of lesion were significant independent risk factors for bleeding, and EMR-P was a significant independent risk factor for perforation after endoscopic resection of colorectal LSTs. |
format | Online Article Text |
id | pubmed-6203567 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-62035672018-11-07 Risk factors for procedure-related complications after endoscopic resection of colorectal laterally spreading tumors Hong, Ji-Yun Kweon, Sun-Seog Lee, Jun Kim, Sang-Wook Seo, Geom-Seog Kim, Hyun-Soo Joo, Young-Eun Medicine (Baltimore) Research Article Colorectal laterally spreading tumors (LSTs) are large and flat elevated neoplasms with diameters of at least 10 mm. Endoscopic resection of LSTs, with their large size and broad base, is difficult and dangerous compared with the resection of polypoid neoplasms. This study aimed to determine the risk factors for procedure-related complications including bleeding and perforation after endoscopic resection of LSTs. Patients with colorectal LST undergoing endoscopic resection at 5 university hospitals in Honam Province of South Korea were enrolled, and their records about patients, lesions, and procedure parameters associated with the occurrence of complications were reviewed retrospectively. Logistic regression analysis was performed to identify risk factors for complications. The frequency of comorbidities in bleeding group was significantly higher than in the no bleeding group. The frequency of bleeding was significantly higher in lesions with adenocarcinoma than in lesions with low or high-grade dysplasia. The frequency of bleeding was significantly higher in piecemeal resection than in en bloc resection. The frequency of perforation was significantly higher in endoscopic mucosal resection-precutting (EMR-P) than in endoscopic mucosal resection (EMR) or endoscopic submucosal dissection. The mean procedure duration was significantly longer in the perforation group than in the no perforation group. On multivariate analysis, patient comorbidity and histologic grade of the lesion were significant independent risk factors for bleeding, whereas EMR-P was a significant independent risk factor for perforation after endoscopic resection. This study demonstrated that patient comorbidity and histologic grade of lesion were significant independent risk factors for bleeding, and EMR-P was a significant independent risk factor for perforation after endoscopic resection of colorectal LSTs. Wolters Kluwer Health 2018-10-12 /pmc/articles/PMC6203567/ /pubmed/30313045 http://dx.doi.org/10.1097/MD.0000000000012589 Text en Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0 |
spellingShingle | Research Article Hong, Ji-Yun Kweon, Sun-Seog Lee, Jun Kim, Sang-Wook Seo, Geom-Seog Kim, Hyun-Soo Joo, Young-Eun Risk factors for procedure-related complications after endoscopic resection of colorectal laterally spreading tumors |
title | Risk factors for procedure-related complications after endoscopic resection of colorectal laterally spreading tumors |
title_full | Risk factors for procedure-related complications after endoscopic resection of colorectal laterally spreading tumors |
title_fullStr | Risk factors for procedure-related complications after endoscopic resection of colorectal laterally spreading tumors |
title_full_unstemmed | Risk factors for procedure-related complications after endoscopic resection of colorectal laterally spreading tumors |
title_short | Risk factors for procedure-related complications after endoscopic resection of colorectal laterally spreading tumors |
title_sort | risk factors for procedure-related complications after endoscopic resection of colorectal laterally spreading tumors |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6203567/ https://www.ncbi.nlm.nih.gov/pubmed/30313045 http://dx.doi.org/10.1097/MD.0000000000012589 |
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