Precordial skin burns after endoscopic submucosal dissection for gastric tube cancer

• Published in: Digestive endoscopy Vol. 27; no. 7; pp. 743 - 747
• Main Authors: Miyagi, Motoshi, Yoshio, Toshiyuki, Hirasawa, Toshiaki, Ishiyama, Akiyoshi, Yamamoto, Yorimasa, Tsuchida, Tomohiro, Fujisaki, Junko, Igarashi, Masahiro
• Format: Journal Article
• Language: English
• Published: Australia Blackwell Publishing Ltd 01.11.2015
• Subjects: Aged; Aged, 80 and over; Burns, Electric - etiology; Burns, Electric - pathology; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - surgery; Dissection - adverse effects; Dissection - methods; Electrocoagulation - adverse effects; endoscopic submucosal dissection; Female; Follow-Up Studies; Gastric Mucosa - surgery; gastric tube cancer; Gastroscopy - adverse effects; Humans; Male; Middle Aged; Postoperative Complications; presternal route reconstruction; Retrospective Studies; Skin - injuries; Skin - pathology; skin burn; Stomach Neoplasms - pathology; Stomach Neoplasms - surgery; thermal injury; endoscopic submucosal dissection; gastric tube cancer; presternal route reconstruction; skin burn; thermal injury
• ISSN: 0915-5635; 1443-1661
• DOI: 10.1111/den.12494

Background and Aim Endoscopic submucosal dissection (ESD) is useful as a minimally invasive treatment option for early gastric cancer. ESD is also used in the management of postoperative remnant gastric cancers in the stomach and gastric tube cancers. Perforation and delayed bleeding have been the main complications of ESD reported in the management of gastric tube cancer. However, in the current literature, there is no description of precordial skin burns caused by electrical coagulation. Methods While we treated 22 patients with gastric tube cancers by ESD from 2005 to 2014, we experienced five skin burns in four patients after ESD. We retrospectively analyzed clinical characteristics of precordial skin burn as a complication of ESD. Results All skin burns occurred in patients reconstructed using a presternal route, whose incidence of precordial skin burn was 55.6%. In all cases, lesions were located in the upper or middle third of gastric tubes irrespective of their direction. Skin burn developed on postoperative day (POD) 1 or POD 2, taking 4–7 days to heal and was accompanied by high fever in 60% of cases. Conclusion The present study suggests that when carrying out ESD for gastric tube cancer using the presternal route, it is necessary to consider the occurrence of a precordial skin burn as a possible complication.