Novel intermittent electrocoagulation technique reduces post-endoscopic submucosal dissection electrocoagulation syndrome in colorectal neoplasms

BACKGROUNDAs colorectal endoscopic submucosal dissection (ESD) is increasingly used, post-ESD electrocoagulation syndrome (PECS) has become an important adverse event. AIM To compare the incidence of PECS between intermittent electrocoagulation (I-ESD)technique and conventional continuous electrocoagulation (C-ESD) during colorectal ESD. METHODSThis retrospective cohort study included patients who underwent colorectal ESD at the First Affiliated Hospital of Ningbo University between November 2023 and November 2024.Procedures were performed by experienced endoscopists, with one using I-ESD and the others using C-ESD.The primary outcome was the incidence of PECS.Secondary outcomes included procedural time, lesion size, resection quality, and adverse events. RESULTSThe cohort included 199 patients, with technical success achieved in all cases.Baseline characteristics were comparable between groups (P > 0.05).The incidence of PECS was significantly lower in the I-ESD group than the C-ESD group (8.5% vs 19.0%; P = 0.033).The median procedural time [42.0, interquartile range (IQR): 30.0-60.0 minutes vs 49.0, IQR: 35.0-62.0minutes; P = 0.057], mean lesion size (20.2 ± 9.4 mm vs 20.4 ± 7.4 mm; P = 0.176), and en bloc and R0 resection rates (P > 0.05) did not differ significantly between the groups.The overall adverse event rate was notably lower in the I-ESD group (P = 0.031).CONCLUSION 4 / 31 As a potentially safer alternative to conventional continuous coagulation, the I-ESD technique significantly reduced the risk of PECS without compromising resection efficiency or safety.