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.
