Prospective cross-organ analysis for the causes of fever and increased inflammatory response after endoscopic resection.

Autor:	Mizutani M; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University, School of Medicine, Tokyo, Japan., Minesaki D; Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University, School of Medicine, Tokyo, Japan., Morioka K; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University, School of Medicine, Tokyo, Japan., Iwata K; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University, School of Medicine, Tokyo, Japan., Miyazaki K; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University, School of Medicine, Tokyo, Japan., Masunaga T; Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University, School of Medicine, Tokyo, Japan., Kubosawa Y; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University, School of Medicine, Tokyo, Japan., Hayashi Y; Center for Preventive Medicine, Keio University, School of Medicine, Tokyo, Japan., Sasaki M; Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University, School of Medicine, Tokyo, Japan., Akimoto T; Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University, School of Medicine, Tokyo, Japan., Takatori Y; Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University, School of Medicine, Tokyo, Japan., Matsuura N; Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University, School of Medicine, Tokyo, Japan., Nakayama A; Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University, School of Medicine, Tokyo, Japan., Sujino T; Center for Diagnostic and Therapeutic Endoscopy, Keio University, School of Medicine, Tokyo, Japan., Takabayashi K; Center for Diagnostic and Therapeutic Endoscopy, Keio University, School of Medicine, Tokyo, Japan., Kanai T; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University, School of Medicine, Tokyo, Japan., Yahagi N; Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University, School of Medicine, Tokyo, Japan., Kato M; Center for Diagnostic and Therapeutic Endoscopy, Keio University, School of Medicine, Tokyo, Japan.
Jazyk:	angličtina
Zdroj:	Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society [Dig Endosc] 2024 Aug; Vol. 36 (8), pp. 918-926. Date of Electronic Publication: 2024 Jan 21.
DOI:	10.1111/den.14740
Abstrakt:	Objectives: Fever and increased inflammatory responses sometimes occur following endoscopic resection (ER). However, the differences in causes according to the organ are scarcely understood, and several modified ER techniques have been proposed. Therefore, we conducted a comprehensive prospective study to investigate the cause of fever and increased inflammatory response across multiple organs after ER. Methods: We included patients who underwent gastrointestinal endoscopic submucosal dissection (ESD) and duodenal endoscopic mucosal resection at our hospital between January 2020 and April 2022. Primary endpoints were fever and increased C-reactive protein (CRP) levels following ER. The secondary endpoints were risk factors for aspiration pneumonia. Blood tests and radiography were performed on the day after ER, and computed tomography was performed if the cause was unknown. Results: Among the 822 patients included, aspiration pneumonia was the most common cause of fever and increased CRP levels after ER of the upper gastrointestinal tract (esophagus, 53%; stomach, 48%; and duodenum, 71%). Post-ER coagulation syndrome was most common after colorectal ESD (38%). On multivariate logistic regression analysis, lesions located in the esophagus (odds ratio [OR] 3.57; P < 0.001) and an amount of irrigation liquid of ≥1 L (OR 3.71; P = 0.003) were independent risk factors for aspiration pneumonia. Conclusions: Aspiration pneumonia was the most common cause of fever after upper gastrointestinal ER and post-ER coagulation syndrome following colorectal ESD. Lesions in the esophagus and an amount of irrigation liquid of ≥1 L were independent risk factors for aspiration pneumonia. (© 2023 Japan Gastroenterological Endoscopy Society.)
Databáze:	MEDLINE
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