ArticleDigestive diseases and sciences2025
Risk Factors, Clinical Course, and Management of Delayed Perforation After Colorectal Endoscopic Submucosal Dissection: A Large-Scale Multicenter Study.
Article in Digestive diseases and sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Endoscopic Closure After Colorectal ESD: A Literature Review and Meta-Analysis on Its Efficacy in Preventing Adverse Events.Diagnostics (Basel, Switzerland) · 2026Review
- Traction Device-Assisted Complete Closure to Prevent Colorectal Post-ESD Coagulation Syndrome.Digestive diseases and sciences · 2026Article
- A novel "twist-and-drag" loop clip technique for closure of mucosal defects after colorectal endoscopic submucosal dissection.Endoscopy · 2026Article
- A >30-cm circumferential rectal laterally spreading tumor treated with multitunnel endoscopic submucosal dissection and suturing.VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy · 2026Article
- Management of Large Non-Pedunculated Polyps of the Colon: Practice-Oriented Answers to Clinical Questions.Journal of clinical medicine · 2026Review
- Endoscopic treatment of gastrointestinal perforations and leaks: Why, when, and how?World journal of gastrointestinal endoscopy · 2026Review
- In Situ Photoactivated Hydrogel Adhesive Dressings for Post Colon Polypectomies (PolypCures).bioRxiv : the preprint server for biology · 2025Article
- Advancements in endoscopic closure: Embracing a new era of managing complications and postprocedural defects after endoscopic submucosal dissection.World journal of gastrointestinal endoscopy · 2025Review
- The effects of different traction devices on colorectal endoscopic submucosal dissection outcomes.Therapeutic advances in gastroenterology · 2025Article
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19 authors.
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Abstract
introductionDelayed perforation (DP) remains a significant complication of colorectal endoscopic submucosal dissection (ESD). This study analyzed the risk factors, clinical course, and management for DP following colorectal ESD.
methodsWe retrospectively reviewed 4,632 consecutive colorectal ESD cases from 13 institutions between January 2006 and May 2024. DP cases were identified, and the incidence rate, along with patient/lesion characteristics (as tumor size, location, and severe fibrosis) were assessed. The clinical course, including onset timing, initial treatments, need for surgery, and risk factors were examined.
resultsDP occurred in 18 cases, with an incidence rate of 0.39% [95% confidence interval (CI): 0.24-0.62]. The mean tumor size was 49.7 ± 35.7 mm. The rates of right-sided colon lesions and severe fibrosis were observed in 77.8 and 61.2%, respectively. DP occurred on post-procedure day 1 in 55.8% of cases, day 2 in 22.2%, and on day 3 or later in 22.2%. Initial DP management included conservative treatment in five cases (27.8%), endoscopic closure in six (33.3%), and surgery in seven cases (38.9%). Among the six cases managed endoscopically, five (83.3%) were successfully managed without surgery. Finally, surgery was required in 11 cases (61.1%). Multivariate analysis (odds ratio [95%CI]) identified severe fibrosis (4.61 [1.50-14.20], p = 0.007), and long procedure time (1.01 [1.00-1.02], p = 0.042), as significant risk factors for DP, while complete closure was inversely correlated with DP risk (0.12 [0.01-0.96], p = 0.046).
conclusionsThis study identified DP incidence and risk factors after colorectal ESD, with some cases requiring surgery. Endoscopic treatment may prevent surgery.
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