Risk factors of electrocoagulation syndrome after esophageal endoscopic submucosal dissection

Table 1 Baseline patient and tumor characteristics n (%)

Characteristic	Value (n = 51)
Number of patients	51
Sex
Male	46 (90.2)
Female	5 (9.8)
Age, mean ± SD, yr	63.6 ± 9.4
Comorbidity
Hypertension	21 (41.2)
Diabetes mellitus	7 (13.7)
Chronic kidney disease	1 (2.0)
Smoker	42 (82.4)
Alcohol consumption	40 (78.4)
Gross appearance of tumor
Polypoid	1 (2.0)
Elevated	8 (15.7)
Flat	40 (78.4)
Depressed	2 (3.9)
Location of tumor
Upper third of esophagus	3 (5.9)
Middle third of esophagus	20 (39.2)
Lower third of esophagus	24 (47.1)
Esophagogastric junction	4 (7.8)
Circumferential extension, median (IQR), %	40 (30-60)
Pathology of tumor
Dysplasia	14 (27.5)
Squamous cell carcinoma	37 (72.5)
Invasion depth of tumor
Mucosa	38 (74.5)
Submucosa	13 (25.5)
Resected area, median (IQR), cm2	4.5 (2.9-8.2)
Procedure time, median (IQR), min	40 (27-69)
Muscle layer exposure
Absent	27 (52.9)
Present	24 (47.1)
En bloc resection	51 (100)
Antibiotics use	23 (45.1)
Post procedure BT, mean ± SD, °C	36.6 ± 0.5
Post procedure WBC, median (IQR), counts/μL	10800 (9340-12600)
Post procedure pain scale score, median (IQR)	5 (3-6)
Duration of hospitalization, median (IQR), d	4 (3-6)
Post ESD electrocoagulation syndrome
Absent	18 (35.3)
Mild	24 (47.1)
Severe	9 (17.6)

SD: Standard deviation; IQR: Interquartile range; BT: Body temperature; WBC: White blood cell.

Table 2 Univariate analysis of risk factors for post endoscopic submucosal dissection electrocoagulation syndrome n (%)

	No PEECS (n = 18)	PEECS (n = 33)	P value
Male sex,	17 (94.4)	29 (87.9)	0.451
Age, mean ± SD, yr	63.6 ± 11.2	63.6 ± 8.5	0.977
Comorbidity			0.769
Absent	9 (50.0)	19 (57.6)
Present	9 (50.0)	14 (42.4)
Gross appearance			0.933
Flat	14 (77.8)	26 (78.8)
Non-flat	4 (22.2)	7 (21.2)
Location			0.378
Upper and middle	10 (55.6)	13 (39.4)
Lower and EGJ	8 (44.4)	20 (60.6)
Circumferential extension, median (IQR), %	35 (30-42.5)	40 (30-60)	0.164
Pathology			0.487
Dysplasia	6 (33.3)	8 (24.2)
Squamous cell carcinoma	12 (66.7)	25 (75.8)
Invasion depth			0.082
Mucosa	16 (88.9)	22 (66.7)
Submucosa	2 (11.1)	11 (33.3)
Resected area			0.035
< 6.0 cm2	15 (83.3)	17 (51.5)
≥ 6.0 cm2	3 (16.7)	16 (48.5)
Procedure time			0.026
< 25 min	7 (38.9)	4 (12.1)
≥ 25 min	11 (61.1)	29 (87.9)
Muscle layer exposure			0.018
Absent	14 (77.8)	13 (39.4)
Present	4 (22.2)	20 (60.6)
Hospitalization period, mean (IQR), d	3.5 (3-4)	5 (4-6)	0.007
Antibiotics use			0.020
No	14 (77.8)	14 (42.4)
Yes	4 (22.2)	19 (57.6)

PEECS: Post endoscopic submucosal dissection electrocoagulation syndrome; SD: Standard deviation; EGJ: Esophagogastric junction; IQR: Interquartile range.

Table 3 Multivariate logistic regression analysis of risk factors for post endoscopic submucosal dissection electrocoagulation syndrome

Factor	OR (95%CI)	P value
Procedure time		0.379
≤ 25 min	Reference
> 25 min	2.032 (0.419-9.868)
Resected area		0.036
≤ 6.0 cm2	Reference
> 6.0 cm2	4.995 (1.110-22.489)
Muscle layer exposure		0.014
Absent	Reference
Present	5.661 (1.422-22.534)