Prospective cohort study explores perforation risks and outcomes in colorectal endoscopic submucosal dissection, indicating the need for careful monitoring.
Key Points
This study aims to investigate the clinical burden and risk factors of perforation during colorectal endoscopic submucosal dissection (ESD).
Analysis of 3770 colorectal ESD procedures performed at 13 centers in Belgium and France from September 2019 to September 2022.
Intraprocedural and delayed perforations were examined in a prospective cohort design.
Multivariable analysis was used to identify factors linked to intraprocedural perforation.
Intraprocedural perforation occurred in 314 cases (8.3%); delayed perforation occurred in 22 cases (0.6%), totaling 336 perforations (8.9%).
Conservative management was effective for 308 perforations (91.7%); 304/314 intraprocedural perforations were managed conservatively (96.8%).
Surgery was needed for 81.8% of delayed perforations (18/22); no deaths were directly linked to perforation.