Endoscopic treatment of large colorectal lesions: A retrospective analysis of efficacy and safety

Table 1 Patient characteristics at baseline, mean ± SD/n (%)

Characteristic	n = 102
Age (years)	63.25 ± 10.7
Sex
Male	52 (51)
Female	50 (49)
Antecedent history
History of smoking	36 (35.35)
History of alcohol	32 (31.4)
Family history	6 (5.9)
Medical history
Hypertension	33 (32.4)
Diabetes	16 (15.7)
Coronary artery disease	14 (13.7)
History of cerebrovascular	8 (7.8)
Disease other	6 (5.9)
Medication history
Antiplatelet drugs	10 (9.8)
Anticoagulants	0

Table 2 Patients’ lesions and perioperative period, n (%)

Lesions and perioperative period	Cases
Lesion site
Cecum	6 (5.9)
Ascending colon	14 (13.7)
Transverse colon	12 (11.8)
Descending colon	3 (2.9)
Sigmoid colon	24 (23.5)
Rectum	43 (42.2)
Morphology of lesions
Polyp-like	26 (25.5)
LST	72 (70.6)
Mucosal bulge	5 (4.9)
Histology
Polyp	2 (2)
Low-grade intraepithelial neoplasia	1 (1)
High-grade intraepithelial neoplasia	28 (27.5)
Adenoma	4 (3.9)
Lipoma	4 (3.9)
Carcinoma	62 (60.8)
Else	1 (1)
Type of excision
Complete resection (R0)	98 (96.1)
En bloc resection	100 (98)
Fractional resection	2 (2)
Horizontal cutting edge
Positive	2 (2)
Negatives	100 (98)
Vertical cutting edge
Positive	0 (0)
Negatives	102 (100)
Placement of intestinal decompression tubes
Yes	46 (45.1)
No	56 (54.9)
Perioperative complications
PEECS	24 (23.5)
Postoperative bleeding	2 (2)
Perforation	0 (0)
Malaise	10 (9.8)
Bloody stool	2 (2)

LST: Laterally spreading tumors; PEECS: Post-endoscopic submucosal dissection electrocoagulation syndrome.

Table 3 Risk factor analysis for post-endoscopic submucosal dissection electrocoagulation syndrome

	β	SE	P value	OR value	95%CI
Age (years)	-0.150	0.022	0.481	0.985	0.944-1.028
Sex [M (0); F (1)]	0.270	0.468	0.565	1.310	0.523-3.279
History of smoking [N (0); Y (1)]	-0.629	0.526	0.232	0.533	0.190-1.495
History of alcohol [N (0); Y (1)]	-1.030	0.596	0.084	0.357	0.111-1.150
BMI > 24 kg/m2 [N (0); Y (1)]	0.657	0.481	0.172	1.929	0.752-4.947
Cerebrovascular disease [N (0); Y (1)]	0.087	0.852	0.919	1.091	0.205-5.795
Coronary artery disease [N (0); Y (1)]	0.307	0.644	0.633	1.060	0.385-4.805
Hypertension [N (0); Y (1)]	0.300	0.488	0.538	1.350	0.519-3.512
Diabetes [N (0); Y (1)]	0.095	0.631	0.880	1.100	0.319-3.791
Taking anti-platelet medication [N (0); Y (1)]	0.371	0.733	0.613	1.449	0.344-6.100
Taking anticoagulants [N (0); Y (1)]	0.103	0.467	0.826	1.108	0.444-2.768
Hemoglobin (g/L)	0.004	0.015	0.807	1.004	0.975-1.033
Blood platelet (× 109/L)	0.003	0.004	0.446	1.003	0.995-1.012
Leucocyte (× 109/L)	0.191	0.150	0.204	1.210	0.902-1.625
PT (seconds)	-0.168	0.215	0.435	0.845	0.554-1.289
APTT (seconds)	-0.027	0.032	0.400	0.974	0.915-1.036
INR	-1.779	3.577	0.619	0.169	0.000-187.008
Serum albumin (g/L)	0.018	0.050	0.717	1.018	0.923-1.123
Cecum [N (0); Y (1)]	0.520	0.899	0.563	1.682	0.289-9.803
Ascending colon [N (0); Y (1)]	0.307	0.644	0.633	1.360	0.385-4.805
Transverse colon [N (0); Y (1)]	1.386	0.635	0.029	4.000	1.153-13.876
Descending colon [N (0); Y (1)]	-20.063	23205.422	0.999	0.000	0.000-0.000
Sigmoid colon [N (0); Y (1)]	-0.545	0.606	0.369	0.580	0.177-1.902
Rectum [N (0); Y (1)]	-0.487	0.489	0.319	0.614	0.235-1.602
Diameter (cm)	0.567	0.197	0.004	1.763	1.199-2.593
Area (cm2)	0.064	0.021	0.003	1.066	1.022-1.112
Polyp-like [N (0); Y (1)]	-1.050	0.652	0.107	0.350	0.097-1.256
LST [N (0); Y (1)]	1.310	0.662	0.048	3.706	1.013-13.551
Mucosal bulge [N (0); Y (1)]	-20.090	17974.843	0.999	0.000	0.000-0.000
High-grade intraepithelial neoplasia [N (0); Y (1)]	0.111	0.517	0.830	1.118	0.406-3.076
Carcinoma [N (0); Y (1)]	0.524	0.505	0.299	1.689	0.628-4.543
No intestinal decompression tubes placed [N (0); Y (1)]	0.013	0.468	0.978	1.013	0.404-2.537

β: Logistic regression coefficient; OR: Odds ratios; CI: Confidence interval; M: Male; F: Female; N: No; Y: Yes; BMI: Body mass index; PT: Pro-thrombin time; APTT: Activated partial thromboplastin time; INR: International normalized ratio; LST: Laterally spreading tumors.

Table 4 Analysis of independent risk factors for post-endoscopic submucosal dissection electrocoagulation syndrome

	β	SE	P value	OR value	95%CI
Transverse colon [N (0); Y (1)]	1.907	0.726	0.009	6.734	1.623-27.945
Diameter (cm)	0.504	0.281	0.073	1.656	0.954-2.873
Area (cm2)	0.363	0.785	0.644	1.438	0.309-6.697
LST [N (0); Y (1)]	1.800	0.936	0.055	6.048	0.965-37.903

β: Logistic regression coefficient; OR: Odds ratio; CI: Confidence interval; N: No; Y: Yes; LST: Laterally spreading tumors.