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Risk Factors for Perforation in Endoscopic Treatment for Early Colorectal Cancer: A Nationwide ENTER-K Study

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Author(s)
Ik Hyun JoHyun Gun KimYoung-Seok ChoHyun Jung LeeEun Ran KimYoo Jin LeeSung Wook HwangKyeong-Ok KimJun LeeHyuk Soon ChoiYunho JungChang Mo Moon
Keimyung Author(s)
Lee, Yoo Jin
Department
Dept. of Internal Medicine (내과학)
Journal Title
Gut Liver
Issued Date
2025
Volume
19
Issue
1
Keyword
Colorectal neoplasmsColonoscopyEndoscopic mucosal resectionIntestinal perforationRisk factors
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.
Keimyung Author(s)(Kor)
이유진
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
2005-1212
Source
https://www.gutnliver.org/journal/view.html?doi=10.5009/gnl240210
DOI
10.5009/gnl240210
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/45976
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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