Intestinal decompression and drainage in preventing post-endoscopic submucosal dissection electrocoagulation syndrome in colorectal ESD: a prospective study.

Background and aims: This study explored the efficacy of a prophylactic intestinal decompression tube in reducing the incidence of post-endoscopic submucosal dissection electrocoagulation syndrome (PECS).

Methods: A total of 157 eligible patients with colorectal mucosal lesions scheduled for endoscopic submucosal dissection (ESD) were prospectively recruited; after drop out 11 patients, 146 patients were randomly assigned to an experimental group (group 1, n = 73) or control group (group 2, n = 73). Patients in the experimental group underwent placement of an intestinal decompression drainage tube after ESD, while the control group received no additional treatment after ESD. The primary outcome was the incidence of PECS. Secondary outcomes included the incidence of postoperative complications, time to removal of the intestinal decompression tube, the degree of abdominal pain as measured by the visual analog scale (VAS), and the participants' self-rated comfort level with the intestinal decompression tube.

Results: A total of 146 patients (n = 73 per group) were finally analyzed between July 2022 and February 2023. All tumors were successfully resected en bloc. A significant difference in the incidence of PECS was found between group 1 and group 2 (5.5% vs 16.4%; P = 0.034). Precisely, 61.6% of patients felt painless for intestinal decompression tube, and no severe or unbearable pain was reported.

Conclusions: The placement of intestinal decompression drainage tube could reduce the incidence of PECS after colorectal ESD, which might play a preventive role in the occurrence of PECS.