The Incidence Of Complications After Endoscopic Submucosal Dissection For Colorectal Tumors And Influencing Factors

Objective To investigate the postoperative complications and influencing factors of endoscopic submucosal dissection for colorectal tumors and to guide clinical work.Methods Retrospective study of clinical data of Endoscopic submucosal dissection in the treatment of intestinal mass from January 2013 to October 2018 in Ningxia people's hospital.After exclusion of clinical data that did not meet the inclusion criteria,86 patients were included in the data.Statistical postoperative complications of ESD(bleeding,perforation).A few patients appear abdominal pain,abdominal distension symptoms.analysis of patients' age,gender,associated underlying diseases(hypertension,coronary heart disease,diabetes),personal history(smoking,drinking),lesions,operation time,postoperative lesion size,operating time,Postoperative pathological results,complete resection and other factors related to postoperative complications of ESD.Results1.Among the 1.86 clinical data,there were 54 males and 32 females with an average age of(51±8.48)years old and a male to female ratio of 1.69:1.30 were associated with underlying hypertension,6 with diabetes,3 with coronary heart disease,24 with smoking,and 16 with alcohol.2.In 86 cases of clinical data,the average size of intestinal tumors was(1.7±1.36)cm,the longest diameter was 6cm,and the shortest diameter was 0.3cm.the average operation time was(98.95±53.98)min,the longest time was 328 min,and the shortest time was 30 min.Complete resection of 81 cases,incomplete resection of 5 cases.3.86 patients underwent endoscopic ESD.15 patients(17.4%)had postoperative blood,including 11 patients(12.8%)after rectal surgery and 4 patients underwent colon surgery(including 2 sigmoid colons,ascending colon 1).For example,1 case of descending colon,the total incidence was 4.7%);2 cases(2.3%)had postoperative perforation.There were 7 cases(8.1%)of postoperative abdominal pain and 7 cases(8.1%)of postoperative abdominal distension.Hemostatic drugs were given to patients with postoperative hemorrhage;one patient with perforation underwent endoscopic titanium clip clamping treatment,and one patient underwent surgery for wound healing;patients with abdominal pain and bloating were treated with symptomatic treatment.4.There were no significant differences in age,gender,coronary heart disease,smoking,alcohol consumption,pathological type,lesion location and postoperative complications of ESD(P>0.05).Surgery time,tumor diameter,diabetes,and complete resection increased the incidence of ESD complications in patients(P<0.05).Hypertension associated with underlying disease can increase the risk of postoperative bleeding in patients(P<0.05).5.Logistic regression analysis showed that the risk factors for complications caused by ESD were: tumor size.Conclusion:1.Bleeding is the most common complication after ESD,There were no significant differences in the general characteristics,lesions,and postoperative pathological types between the ESD postoperative complications group and the non-complication group.2.The size of the tumor is an independent risk factor for postoperative complications of ESD.Complications are more likely to occur if the diameter is greater than equal to 2cm.The factors such as operation time,diabetes,and complete resection are the risk factors for postoperative complications of ESD.A reasonable surgical plan and preventive measures should be developed after comprehensive evaluation of the patient's condition.