首页|Assessment of the validity of the clinical pathway for colon endoscopic submucosal dissection
Assessment of the validity of the clinical pathway for colon endoscopic submucosal dissection
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NETL
NSTL
万方数据
维普
AIM:To determine the effective hospitalization period as the clinical pathway to prepare patients for endoscopic submucosal dissection (ESD).METHODS:This is a retrospective observational study which included 189 patients consecutively treated by ESD at the National Cancer Center Hospital from May 2007 to March 2009.Patients were divided into 2 groups; patients in group A were discharged in 5 d and patients in group B included those who stayed longer than 5 d.The following data were collected for both groups:mean hospitalization period,tumor site,median tumor size,post-ESD rectal bleeding requiring urgent endoscopy,perforation during or after ESD,abdominal pain,fever above 38 ℃,and blood test results positive for inflammatory markers before and after ESD.Each parameter was compared after data collection.RESULTS:A total of 83％ (156/189) of all patients could be discharged from the hospital on day 3 postESD.Complications were observed in 12.1％ (23/189)of patients.Perforation occurred in 3.7％ (7/189) of patients.All the perforations occurred during the ESD procedure and they were managed with endoscopic clipping.The incidence of post-operative bleeding was 2.6％ (5/189); all the cases involved rectal bleeding.We divided the subjects into 2 groups:tumor diameter ≥ 4 cm and ＜ 4 cm; there was no significant difference between the 2 groups (P =0.93,x2 test with Yates correction).The incidence of abdominal pain was 3.7％ (7/189).All the cases occurred on the day of the procedure or the next day.The median white blood cell count was 6800 ± 2280 (cells/μL; ± SD) for group A,and 7700 ± 2775 (cells/μL; ± SD) for group B,showing a statistically significant difference (P =0.023,t-test).The mean C-reactive protein values the day after ESD were 0.4 ± 1.3 mg/dL and 0.5 ± 1.3 mg/dL for groups A and B,respectively,with no significant difference between the 2 groups (P =0.54,t-test).CONCLUSION:One-day admission is sufficient in the absence of complications during ESD or early postoperative bleeding.
NETL
NSTL
万方数据
维普
