High total Joule heat increases the risk of post-endoscopic submucosal dissection electrocoagulation syndrome after colorectal endoscopic submucosal dissection

Table 1 Characteristics of patients who underwent endoscopic submucosal dissection, n (%)

Patient features	n (%)
Number of patients	151
Male	94 (62.3)
Age (yr), mean ± SD	67.3 ± 10.9
BMI (kg/m2), mean ± SD	22.9 ± 3.0
Specimen size
< 40 mm	132 (87.4)
≥ 40 mm	19 (12.6)
Total Joule heat
< 8460 J1	75 (49.7)
≥ 8460 J	76 (50.3)
Tumor location
Right colon	59 (39.1)
Left colon	41 (27.1)
Rectum	51 (33.8)
Tumor morphology
0-Is/Ip	29 (19.2)
LST-G	75 (49.7)
LST-NG (0-IIc)	47 (31.1)
Depth of pathological invasion
Tis (M)	130 (86.1)
T1 (SM)	21 (13.9)
Histological diagnosis
Adenoma	67 (44.4)
Adenocarcinoma	80 (53.0)
Other	4 (2.6)
ECOG performance status after ESD
0	144 (95.4)
≥1	7 (4.6)
R0 resection	115 (76.2)
ESD procedure performed by trainees	52 (34.4)
Additional endoscopic therapy after ESD	2 (1.3)
Additional surgery after ESD	12 (7.9)
En bloc resection	135 (89.4)
Intraoperative perforation or penetration	7 (4.6)
Submucosal fibrosis	45 (29.8)
PECS	16 (10.6)

¹Patients exposed to more or less than the median Joule heat value (8460 J) were assigned to the high and low Joule heat groups, respectively.

BMI: Body mass index; Is: Sessile type; Ip: Pedunculated type; LST-G: Lateral spreading tumor granular type; LST-NG: Lateral spreading tumor non-granular type; IIc: Superficial depressed type; Tis (M): Carcinoma in situ or intramucosal carcinoma; T1 (SM): Tumor invades submucosa; R0: Microscopically margin-negative; ESD: Endoscopic submucosal dissection; PECS: Post-endoscopic submucosal dissection electrocoagulation syndrome; SD: Standard deviation; ECOG performance status: Eastern Cooperative Oncology Group performance status.