CURRENT STATUS OF CLINICAL PATHWAY FOR COLORECTAL ESD IN FACILITIES PARTICIPATING IN THE COLORECTAL ESD LONG-TERM OUTCOMES STUDY (CREATE-J): A MULTI-INSTITUTIONAL SURVEY OF 20 FACILITIES

DOI
  • TOKURA Junki
    Cancer Institute Hospital, Japanese Foundation for Cancer Research.
  • CHINO Akiko
    Cancer Institute Hospital, Japanese Foundation for Cancer Research.
  • KOBAYASHI Nozomu
    Department of Gastroenterology, Tochigi Cancer Center. Endoscopy Division, National Cancer Center Hospital.
  • OHATA Ken
    Department of Gastrointestinal Endoscopy, NTT Medical Center.
  • TAKEUCHI Yoji
    Department of Gastrointestinal Oncology, Osaka International Cancer Institute.
  • SAITO Shoichi
    Cancer Institute Hospital, Japanese Foundation for Cancer Research.
  • YAMADA Masayoshi
    Endoscopy Division, National Cancer Center Hospital.
  • TSUJI Yosuke
    Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo.
  • HOTTA Kinichi
    Division of Endoscopy, Shizuoka Cancer Center.
  • HARADA Keita
    Department of Gastroenterology, Okayama University Hospital.
  • IKEMATSU Hiroaki
    Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East.
  • TAKATORI Yusaku
    Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine.
  • URAOKA Toshio
    Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine. Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine.
  • MURAKAMI Takashi
    Department of Gastroenterology, Juntendo University Hospital.
  • TSUJI Shigetsugu
    Department of Gastroenterology, Ishikawa Prefectural Central Hospital.
  • KATAGIRI Atsushi
    Division of Gastroenterology, Department of Medicine, Showa University School of Medicine.
  • HORI Shinichiro
    Department of Gastroenterology, NHO Shikoku Cancer Center. Department of Gastroenterology, Japanese Red Cross Society Himeji Hospital.
  • MICHIDA Tomoki
    Department of Gastrointestinal Oncology, Osaka International Cancer Institute. Department of Internal Medicine, Japan Community Healthcare Organization Osaka Hospital.
  • SUZUKI Takuto
    Department of Gastroenterology, Chiba Cancer Center.
  • FUKUZAWA Masakatsu
    Department of Gastroenterology and Hepatology, Tokyo Medical University.
  • KIRIYAMA Shinsuke
    Department of Surgery, Gunma Chuo General Hospital.
  • FUKASE Kazutoshi
    Department of Internal Medicine, Yamagata Prefectural Central Hospital. Department of Internal Medicine, Yamagata Prefectural Kahoku Hospital.
  • MURAKAMI Yoshitaka
    Department of Medical Statistics, Toho University.
  • ISHIKAWA Hideki
    Department of Molecular-Targeting Cancer Prevention, Kyoto Prefectural University of Medicine.
  • SAITO Yutaka
    Endoscopy Division, National Cancer Center Hospital.

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  • 大腸ESD長期予後研究（CREATE-J）参加施設における大腸ESDに対するクリニカルパスの現状―多施設共同（20施設）アンケート調査―

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Abstract

<p>Background and Aim:ESD is often performed using a clinical pathway schedule in Japan; however, the evidence according to such a pathway was still lacking. Hence, the purpose of this study was to investigate the current status of clinical pathways in specialized facilities that perform numerous ESDs of the colon.</p><p>Methods:A questionnaire survey was conducted on common points and adverse events related to ESD in 20 facilities participating in a long-term follow-up study of colon ESD (the Colorectal ESD Activation Team of Japan, CREATE-J).</p><p>Results:The median length of hospital stay was 5 days, and in 89.5% of the facilities, ESD was performed on the day after hospitalization, with patients being allowed to start eating on the second day after ESD in 57.9% of the facilities. Fifty-five percent of the facilities strengthened the pretreatment, 60% did not perform a post-treatment radiographic examination, and 60% performed blood tests only on the day after treatment. The frequency of adverse events was as follows: delayed bleeding, 2.2%; delayed perforation, 0.6%; and peritonitis, 0.3%. The corresponding median times to onset of these adverse events were the second day of treatment, 42 h after treatment, and 16.5 h after treatment.</p><p>Conclusion:The clinical pathways for ESD in the CREATE-J participating facilities were appropriately designed in terms of hospital stay duration to prioritize patient safety.</p>

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