Factors associated with pyrexia after gastric endoscopic submucosal dissection

Abstract

Background and Purpose: Endoscopic submucosal dissection (ESD) has been identified as the standard treatment for superficial gastric neoplasms. However, pyrexia is sometimes observed during postoperative course, the clinical significance yet to be identified. Therefore, we investigated these concerns focusing on the electrocoagulation syndrome. Methods: We retrospectively assessed a total of 422 patients who undergone gastric ESD in a single institution between January 2014 and December 2020. They were divided into two groups, Pyrexia (38.0°C or higher) group (n=79) and No-pyrexia group (n=343) and compared with background characteristics and treatment outcomes using propensity-score matching analysis. Results: Propensity-score matching analysis yielded 79 pairs. This comparison demonstrated a significant difference for the following outcomes: the number of penetrating blood vessels (P=0.017), WBC count (P<0.0001), and CRP value (P=0.0002). Others were similar values for outcomes. Histopathological examination revealed the possibility of thermal degeneration of the muscle layer around penetrating blood vessels. Conclusion: This study indicated that excessive preventative hemostasis for penetrating blood vessels might cause the electrocoagulation syndrome leading to pyrexia after ESD.