Risk Factors for Post-Endoscopic Submucosal Dissection Electrocoagulation Syndrome in Patients with Colorectal Neoplasms - A Multicenter, Large-Scale, Retrospective Cohort Study by the Honam Association for the Study of Intestinal Disease (HASID)

Q: What is post-ESD electrocoagulation syndrome (PECS) after colorectal ESD?

PECS is a complication diagnosed clinically by localized abdominal pain and fever or inflammatory response after ESD without evidence of perforation.

Q: What is the overall incidence of PECS in this study?

The incidence rate of PECS was 2.6%, affecting 37 patients (from 1413 lesions in 1408 patients).

Q: Which factors independently increase the risk of PECS after colorectal ESD?

Anti-platelet agent use, lesion size greater than 6 cm, deep submucosal invasion, and ESD procedure time of at least 60 minutes were independent risk factors.

Sep 21, 2026

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Colorectal endoscopic submucosal dissection (ESD) effectively removes large or cancerous colorectal neoplasms, yet post-ESD electrocoagulation syndrome (PECS) remains insufficiently studied. This multicenter retrospective cohort analyzed 1413 lesions from 1408 patients treated at five tertiary hospitals (2015–2020) to determine PECS incidence, identify risk factors, and build a prediction model. PECS occurred in 2.6% of lesions. Independent predictors were anti-platelet agent use, lesion size >6 cm, deep submucosal invasion, and ESD time ≥60 min, and increasing scores corresponded to rising PECS incidence (1.3% to 16.6%), supporting prevention.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages11

Reading Time28 min

AccessFree to download

Introduction

Background of colorectal ESD and PECS

Materials and Methods

Study design and patient cohort

Outcome assessment and risk factor analysis

Results

Incidence of PECS

Multivariate risk factors and risk-scoring model performance

Conclusions

Clinical implications for prediction and prevention

Journal of Clinical Medicine Article Risk Factors for Post-Endoscopic Submucosal Dissection Electrocoagulation Syndrome in Patients with Colorectal Neoplasms: A Multicenter, Large-Scale, Retrospective Cohort Study by the Honam Association for the Study of Intestinal Disease (HASID) Hyo-Yeop Song 1,†, Seong-Jung Kim 2,†, Jun Lee 2, Byung Chul Jin 3, Dong Hyun Kim 4, Hyun-Soo Kim 4, Hyung-Hoon Oh 4, Young-Eun Joo 4, Dae-Seong Myung 4, Sang-Wook Kim 3, *,‡ and Geom-Seog Seo 1, *,‡ Citation: Song, H.-Y.; Kim, S.-J.; Lee, J.; Jin, B.C.; Kim, D.H.; Kim, H.-S.; Oh, H.-H.; Joo, Y.-E.; Myung, D.-S.; Kim, S.-W.; et al. Risk Factors for Post-Endoscopic Submucosal Dissection Electrocoagulation Syndrome in Patients with Colorectal Neoplasms: A Multicenter, Large-Scale, Retrospective Cohort Study by the Honam Association for the Study of Intestinal Disease (HASID). J. Clin. Med. 2024, 13, 3932 . [https://doi.org/10.3390/jcm13133932](https://doi.org/10.3390/jcm13133932) Academic Editor: Hajime Isomoto Received: 16 June 2024 Revised: 2 July 2024 Accepted: 3 July 2024 Published: 4 July 2024 Copyright: © 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) . 1 Department of Internal Medicine and Digestive Disease Research Institute, Wonkwang University School of Medicine, Iksan 54538, Republic of Korea; [bfsongc@hanmail.net](bfsongc@hanmail.net) 2 Department of Internal Medicine, College of Medicine, Chosun University, Gwangju 61452, Republic of Korea; [ygegh@hanmail.net](ygegh@hanmail.net) (S.-J.K.); [leejun@med.chosun.ac.kr](leejun@med.chosun.ac.kr) (J.L.) 3 Department of Internal Medicine, Research Institute of Clinical Medicine, Biomedical Research Institute, Jeonbuk National University, Jeonbuk National Medical School, Jeonju 54907, Republic of Korea; [jasmintaste@gmail.com](jasmintaste@gmail.com) 4 Department of Internal Medicine, Chonnam National University Medical School, Gwangju 61469, Republic of Korea; [bono343@naver.com](bono343@naver.com) (D.H.K.); [dshskim@hanmail.net](dshskim@hanmail.net) (H.-S.K.); [hyung1125@naver.com](hyung1125@naver.com) (H.-H.O.); [yejoo@chonnam.ac.kr](yejoo@chonnam.ac.kr) (Y.-E.J.); [myungdaeseong@hanmail.net](myungdaeseong@hanmail.net) (D.-S.M.) * Correspondence: [clickm@jbnu.ac.kr](clickm@jbnu.ac.kr) (S.-W.K.); [medsgs@wonkwang.ac.kr](medsgs@wonkwang.ac.kr) (G.-S.S.); Tel.: +82-10-9216-7915 (S.-W.K.); +82-10-8990-9428 (G.-S.S.)† These authors contributed equally to this work as first authors. ‡ These authors contributed equally to this work as correspondence. Abstract: Background and Objectives: Colorectal endoscopic submucosal dissection (ESD) is an effective technique for removing colorectal neoplasms with large or cancerous lesions. However, there are few studies on post-ESD electrocoagulation syndrome (PECS), a complication of colorectal ESD. Therefore, this study aimed to investigate the various risk factors for PECS after colorectal ESD. Materials and Methods: We retrospectively analyzed the medical records of 1413 lesions from 1408 patients who underwent colorectal ESD at five tertiary hospitals between January 2015 and December 2020 . We investigated the incidence and risk factors associated with PECS. Based on the data, we developed a risk-scoring model to predict the risk of PECS after colorectal ESD. Results: The incidence rate of PECS was 2.6%(37 patients) . In multivariate analysis, the use of anti-platelet agents (odds ratio (OR), 2.474; 95% confidence interval (CI), 1.088–5.626; p < 0.031), a lesion larger than 6 cm (OR 3.755; 95% CI, 1.237–11.395; p = 0.028), a deep submucosal invasion (OR 2.579; 95% CI, 1.022–6.507; p = 0.045), and an ESD procedure time ≥ 60 mi

FAQs

What is post-ESD electrocoagulation syndrome (PECS) after colorectal ESD?

PECS is a complication diagnosed clinically by localized abdominal pain and fever or inflammatory response after ESD without evidence of perforation.

What is the overall incidence of PECS in this study?

The incidence rate of PECS was 2.6%, affecting 37 patients (from 1413 lesions in 1408 patients).

Which factors independently increase the risk of PECS after colorectal ESD?

Anti-platelet agent use, lesion size greater than 6 cm, deep submucosal invasion, and ESD procedure time of at least 60 minutes were independent risk factors.

Sep 21, 2026

Uploaded by Aria