Gut Liver.
2025 Jan;19(1):95-107. 10.5009/gnl240210.
Risk Factors for Perforation in Endoscopic Treatment for Early Colorectal Cancer: A Nationwide ENTER-K Study
- Affiliations
-
- 1Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- 2Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea
- 3Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- 4Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
- 5Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- 6Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
- 7Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- 8Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
- 9Department of Internal Medicine, Chosun University College of Medicine, Gwangju, Korea
- 10Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
- 11Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea
- 12Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea
- KMID: 2564738
- DOI: http://doi.org/10.5009/gnl240210
Abstract
- Background/Aims
Early colorectal cancer (ECC) is commonly resected endoscopically. Perforation is a devastating complication of endoscopic resection. We aimed to identify the characteristics and predictive risk factors for perforation related to endoscopic resection of ECC.
Methods
This nationwide retrospective multicenter study included patients with ECC who underwent endoscopic resection. We investigated the demographics, endoscopic findings at the time of treatment, and histopathological characteristics of the resected specimens. Logistic regression analysis was used to investigate the clinical factors associated with procedure-related perforations. Survival analysis was conducted to assess the impact of perforation on the overall survival of patients with ECC.
Results
This study included 965 participants with a mean age of 63.4 years. The most common endoscopic treatment was conventional endoscopic mucosal resection (n=573, 59.4%), followed by conventional endoscopic submucosal dissection (n=259, 26.8%). Thirty-three patients (3.4%) experienced perforations, most of which were managed endoscopically (n=23/33, 69.7%). Patients who undergo endoscopic submucosal dissection-hybrid and precut endoscopic mucosal resection have a higher risk of perforation than those who undergo conventional endoscopic mucosal resection (odds ratio, 78.65 and 39.72, p<0.05). Procedure-related perforations were not associated with patient survival.
Conclusions
Perforation after endoscopic resection had no significant impact on the prognosis of ECC. The type of endoscopic resection was a crucial predictor of perforation. Large-scale prospective studies are needed to further investigate endoscopic resection of ECC.
- Full Text Links
-
- Actions
-
Cited
- CITED
-
- Close
- Share
-
- Similar articles
-
- Endoscopic diagnosis and treatment of early colorectal cancer
- Multivariate Analysis of the Risk Factors Associated with Complications and Mortality after and Emergency Operation for Obstructive, Perforated Colorectal Cancer
- Unexpected Delayed Colon Perforation after the Endoscopic Submucosal Dissection with Snaring of a Laterally Spreading Tumor
- Screening strategy for colorectal cancer according to risk
- Risk Factors for Lymph Node Metastasis after Endoscopic Resection for Early Colorectal Cancer
