Frequency of Bacteremia After Endoscopic Submucosal Dissection for Upper Gastrointestinal Neoplasm

Abstract

Background: Endoscopic submucosal dissection (ESD) was widely utilized for the resection of superficial neoplasm in gastrointestinal tract. However, few data are available regarding the frequency of bacteremia after ESD. This studyprospectively evaluated the frequency of bacteremia after ESD for UGI neoplasm. Methods: A total of 66 patients underwent ESD for UGI neoplasm was enrolled in this prospective study. Blood cultures were obtained 10 minutes after, and 2 hours after the procedure for both aerobic and anaerobic bacteria. Results: Among the 66 enrolled patients, six cases underwent ESD for early esophageal cancer, 35 for early gastric cancer, 3 for esophageal subepithelial tumors, and 22 for gastric subepithelial tumors. Perforations occurred in 2 patients who underwent ESD for superficial or subepithelial esophageal tumors and another 4 cases for superficial or subepithelial gastric tumors. None of these patients received surgical repair. Post-operative fever was observed from 8 patients (12.1%). Two patients (3.0 %) showed a positive blood culture result at 10 minutes after the procedure. The isolated microorganisms were coag (-) staphylococcus and Ps. aeruginosa. One of 6 patients suffered from perforation during ESD was detected bacteremia of Ps. aeruginosa and treated by antibiotics without sequela. No single patient has developed infective endocarditis during this study period. Conclusion: ESD for the upper GI tract was a low risk procedure for arising infectious complications. Prophylactic administration of antibiotics before or after ESD is not indicated.