CURRENT STATUS OF CLINICAL PATHWAY FOR COLORECTAL ESD IN FACILITIES PARTICIPATING IN THE COLORECTAL ESD LONG-TERM OUTCOMES STUDY (CREATE-J): A MULTI-INSTITUTIONAL SURVEY OF 20 FACILITIES

Abstract

Background and Aim:ESD is often performed using a clinical pathway schedule in Japan; however, the evidence according to such a pathway was still lacking. Hence, the purpose of this study was to investigate the current status of clinical pathways in specialized facilities that perform numerous ESDs of the colon.

Methods:A questionnaire survey was conducted on common points and adverse events related to ESD in 20 facilities participating in a long-term follow-up study of colon ESD (the Colorectal ESD Activation Team of Japan, CREATE-J).

Results:The median length of hospital stay was 5 days, and in 89.5% of the facilities, ESD was performed on the day after hospitalization, with patients being allowed to start eating on the second day after ESD in 57.9% of the facilities. Fifty-five percent of the facilities strengthened the pretreatment, 60% did not perform a post-treatment radiographic examination, and 60% performed blood tests only on the day after treatment. The frequency of adverse events was as follows: delayed bleeding, 2.2%; delayed perforation, 0.6%; and peritonitis, 0.3%. The corresponding median times to onset of these adverse events were the second day of treatment, 42 h after treatment, and 16.5 h after treatment.

Conclusion:The clinical pathways for ESD in the CREATE-J participating facilities were appropriately designed in terms of hospital stay duration to prioritize patient safety.