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Electrocoagulation syndrome after endoscopic submucosal dissection (ESD) is very similar to postpolypectomy syndrome after polyp removal via endoscopic mucosal resection (EMR). The symptoms are abdominal pain, fever, leukocytosis and left shift, and localized abdominal tenderness and possible peritoneal findings on physical examination. After ESD in the colorectum, the risk of the syndrome has been as high as 40%.
To examine whether use of prophylactic antibiotics could reduce incidence of electrocoagulation syndrome after colorectal ESD, researchers in Korea randomized 100 patients to receive intravenous ampicillin-sulbactam or a control infusion of normal saline 1 hour before ESD, followed by two additional infusions at 8-hour intervals.
Th…