Open Access
Endosc Int Open 2014; 02(03): E141-E147
DOI: 10.1055/s-0034-1377274
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Risk factors for pyrexia after endoscopic submucosal dissection of gastric lesions

Takayuki Nakanishi
Department of Gastroenterology, Gifu University Graduate School of Medicine, Gifu, Japan
,
Hiroshi Araki
Department of Gastroenterology, Gifu University Graduate School of Medicine, Gifu, Japan
,
Noritaka Ozawa
Department of Gastroenterology, Gifu University Graduate School of Medicine, Gifu, Japan
,
Jun Takada
Department of Gastroenterology, Gifu University Graduate School of Medicine, Gifu, Japan
,
Masaya Kubota
Department of Gastroenterology, Gifu University Graduate School of Medicine, Gifu, Japan
,
Kenji Imai
Department of Gastroenterology, Gifu University Graduate School of Medicine, Gifu, Japan
,
Fumito Onogi
Department of Gastroenterology, Gifu University Graduate School of Medicine, Gifu, Japan
,
Takashi Ibuka
Department of Gastroenterology, Gifu University Graduate School of Medicine, Gifu, Japan
,
Makoto Shiraki
Department of Gastroenterology, Gifu University Graduate School of Medicine, Gifu, Japan
,
Masahito Shimizu
Department of Gastroenterology, Gifu University Graduate School of Medicine, Gifu, Japan
,
Hisataka Moriwaki
Department of Gastroenterology, Gifu University Graduate School of Medicine, Gifu, Japan
› Author Affiliations
Further Information

Publication History

submitted08 April 2014

accepted after revision18 April 2014

Publication Date:
10 July 2014 (online)

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Abstract

Background and study aims: Endoscopic submucosal dissection (ESD) is widely used in the resection of gastric tumors en bloc, however, complications such as pyrexia frequently occur following the procedure. The study aim was to elucidate the incidence, clinical characteristics, and risk factors of post-ESD pyrexia.

Patients and methods: We conducted a retrospective cohort study of 471 consecutive patients with 485 gastric lesions resected by ESD between December 2005 and 2010. Pyrexia was defined as body temperature above 37.5 °C, regardless of its duration.

Blood tests and chest radiography were performed three times before and after ESD. Chest and abdominal computed tomography (CT) was taken on postoperative day 1.

Results: Post-ESD pyrexia developed in 117 patients (24.8 %), including 40 patients with pneumonia as shown by computed tomography. The pyrexia was resolved in all the patients after 1 day (median; range, 1 – 36 days). A multivariate analysis identified age (P = 0.0029) and resection diameter (P = 0.0009) as risk factors for pyrexia in patients without pneumonia, and operation time (P = 0.0025) as a risk factor for pyrexia in patients with pneumonia.

Conclusion: The patient would be at risk for post-ESD pyrexia if a large ESD is performed in the elderly. The longer operation time would raise the risk for pneumonia-associated fever.