Predictive Factors for Fever After Endoscopic Submucosal Dissection in Colorectal Lesions

Aims Endoscopic submucosal dissection (ESD) is recommended for removal of colonic and rectal lesions with high suspicion of limited submucosal invasion. Fever is one of the most frequent side effects after this procedure. However, predictive factors for fever after-ESD, as well as the potential benefit of antibiotic prophylaxis remain unknown. Our goal was to identify risk factors for fever after-ESD.

Methods Retrospective cohort study including consecutive patients who underwent ESD for colorectal lesions, between 2018 and 2020. The primary outcome was fever, defined as a temperature higher than 38ºC. Predictive factors for fever were explored, including antibiotic prophylaxis.

Results Overall, we included 41 patients corresponding to 41 different colorectal lesions (median size 35 mm, IQR [22.5-50]). Most lesions were located in the rectum (78 %). Orotracheal intubation was performed in 58.5 % of cases and the median duration time was 85 minutes (IQR [45-150]). Fever occurred in 19.5 % (n = 8) and 1 patient had positive blood culture. Antibiotics were initiated in 15 % of all cases. Lesion size (55 vs 35 mm, p=0.04) and procedure time (180 vs 75 min, p=0.02) were associated to fever after-ESD. Age (72 vs 64 years, p=0.51), lesion location (21.8 % vs 11.1 %) and need for orotracheal intubation (29 % vs 6 %, p=0.11) did not influence the development of fever after-ESD. Patients with fever had a higher hospitalization time (OR 2.2, 95 % CI [1.17-4.19], p=0.02).

Conclusions In colorectal ESD, bigger lesion size and longer procedure time were associated to fever. Patients with fever after-ESD had higher hospitalization time.

Citation: Frias Gomes C, Revés J, Morão B et al. eP232 PREDICTIVE FACTORS FOR FEVER AFTER ENDOSCOPIC SUBMUCOSAL DISSECTION IN COLORECTAL LESIONS. Endoscopy 2021; 53: S174.

Publication History

Article published online:
19 March 2021