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

• Published in: Surgical endoscopy Vol. 36; no. 1; pp. 314 - 320
• Main Authors: Tanabe, Hiroaki, Higurashi, Takuma, Takatsu, Tomohiro, Misawa, Noboru, Yoshihara, Tsutomu, Goto, Shungo, Arimoto, Jun, Ashikari, Keiichi, Taniguchi, Leo, Chiba, Hideyuki, Nakajima, Atsushi
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-01-2022; Springer Nature B.V
• Subjects: Abdomen; Abdominal Surgery; Colorectal cancer; Colorectal Neoplasms - surgery; Constipation; Endoscopic Mucosal Resection - adverse effects; Endoscopic Mucosal Resection - methods; Endoscopy; Gastroenterology; Gastrointestinal Neoplasms - surgery; Gynecology; Hepatology; Humans; Medicine; Medicine & Public Health; Observational studies; Postoperative period; Proctology; Prospective Studies; Questionnaires; Surgery; Treatment Outcome; Endoscopic submucosal dissection; Gastrointestinal symptom rating scale; Abdominal symptoms; Colorectal cancer; Quality of life
• ISSN: 0930-2794; 1432-2218
• DOI: 10.1007/s00464-020-08278-w

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.