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Effects of colorectal endoscopic submucosal dissection on postoperative abdominal symptoms: a prospective observational study

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Abstract

Background

Endoscopic submucosal dissection (ESD) is an effective procedure to resect large superficial gastrointestinal neoplasms. In gastric ESD, several studies showed the relationship between postoperative abdominal symptoms and endoscopic treatment. However, the influence of colorectal ESD on abdominal symptoms after treatment is still unknown. To the best of our knowledge, this is the first prospective multicenter study performed to investigate the impact of colorectal ESD on postoperative abdominal symptoms. This study aimed to clarify the association between change of abdominal symptoms and ESD.

Methods

This study was a prospective multicenter observational trial that enrolled 141 out of 171 patients who underwent colorectal ESD and answered the Gastrointestinal Symptom Rating Scale (GSRS) questionnaire from March 2015 to August 2019. We evaluated abdominal symptoms in the patients using the GSRS questionnaire before ESD and a few weeks after ESD.

Results

Comparing the GSRS before and after ESD, overall scores changed from 1.58 ± 0.58 to 1.48 ± 0.48, and the five subscales (reflux syndrome, abdominal pain, indigestion syndrome, diarrhea syndrome, and constipation syndrome) were slightly improved. Overall scores, indigestion syndrome, and constipation syndrome were statistically significantly different before and after ESD (P < 0.05).

Conclusions

In GSRS, a score of ≥ 3 is often treated as a clinically significant symptom. Therefore, our findings indicated that there was no clinically significant difference. For this reason, colorectal ESD does not affect postoperative abdominal symptoms and is considered a minimally invasive treatment.

The analysis of the impact of colon ESD on gastrointestinal symptoms UMIN000016914.

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Acknowledgements

The authors thank the staff of the participating each institution for their support in collecting data and the patients who participated in this study.

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan

    Hiroaki Tanabe, Takuma Higurashi, Tomohiro Takatsu, Noboru Misawa, Tsutomu Yoshihara, Keiichi Ashikari, Hideyuki Chiba & Atsushi Nakajima

  2. Department of Gastroenterology, Hiratsuka City Hospital, Hiratsuka, Japan

    Shungo Goto, Jun Arimoto & Leo Taniguchi

Authors
  1. Hiroaki Tanabe
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  2. Takuma Higurashi
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  3. Tomohiro Takatsu
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  4. Noboru Misawa
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  5. Tsutomu Yoshihara
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  6. Shungo Goto
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  7. Jun Arimoto
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  8. Keiichi Ashikari
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  9. Leo Taniguchi
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  10. Hideyuki Chiba
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  11. Atsushi Nakajima
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Contributions

Study concept and design: HT, TH, JA, and AN. Collection of the data: HT, TH, TT, NM, TY, SG, JA, KA, LT, and HC. Analysis and interpretation of the data: HT, TH, NM, and KA. Critical revision of the article for important intellectual content: HT, TH, NM, and KA. Final approval of the article: All authors.

Corresponding author

Correspondence to Atsushi Nakajima.

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Disclosures

Drs. Hiroaki Tanabe, Takuma Higurashi, Tomohiro Takatsu, Noboru Misawa, Tsutomu Yoshihara, Shungo Goto, Jun Arimoto, Keiichi Ashikari, Leo Taniguchi, Hideyuki Chiba, and Atsushi Nakajima have no conflicts of interest or financial ties to disclose.

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Tanabe, H., Higurashi, T., Takatsu, T. et al. Effects of colorectal endoscopic submucosal dissection on postoperative abdominal symptoms: a prospective observational study. Surg Endosc 36, 314–320 (2022). https://doi.org/10.1007/s00464-020-08278-w

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  • DOI: https://doi.org/10.1007/s00464-020-08278-w

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