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Journals / Journal of Medicine and Palliative Care / 2026 / Volume: 7 Issue: 2

Impact of swift versusspray coagulation on procedural outcomes in colorectal endoscopic submucosal dissection

Berk Baş(İSTANBUL AYDIN ÜNİVERSİTESİ)0000-0002-0652-2147
Ömer Küçükdemirci(ONDOKUZ MAYIS UNIVERSITY)0000-0001-7642-2793
Altay Kandemir(ADNAN MENDERES UNIVERSITY)0000-0002-2918-3811
İsmail Taşkıran(ADNAN MENDERES UNIVERSITY)0000-0001-5450-5133
Mehmet Hadi Yaşa(ADNAN MENDERES UNIVERSITY)0000-0002-0571-2766
Halil Şahin(ISTANBUL AYDIN UNIVERSITY)0000-0002-2718-0326
Müge Erdem Çağı(ADNAN MENDERES UNIVERSITY)0009-0009-3322-6528
Pages
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Publication Date
2026-03-27
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Prospective multicenter studies are warranted to confirm these results.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Aims: Endoscopic submucosal dissection (ESD) is an established technique for the curative resection of large colorectal lesions; however, intraoperative bleeding remains a major technical challenge.
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Key Findings & Data:Methods: This retrospective, single-center study included 594 consecutive patients who underwent colorectal ESD between January 2021 and December 2025.
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Conclusion & Impact:Prospective multicenter studies are warranted to confirm these results.
🔬Design:Research Article
📍Scope:2021 Verileri
⚙️Variables:ESD · outcome · Spray

Abstract

Aims: Endoscopic submucosal dissection (ESD) is an established technique for the curative resection of large colorectal lesions; however, intraoperative bleeding remains a major technical challenge. Electrosurgical coagulation modes are modifiable procedural factors that may influence bleeding control and procedural efficiency. This study aimed to compare the clinical outcomes of Swift and Spray coagulation modes during colorectal ESD. Methods: This retrospective, single-center study included 594 consecutive patients who underwent colorectal ESD between January 2021 and December 2025. Patients were divided into the Spray and Swift coagulation groups according to the coagulation mode used during submucosal dissection. Procedural characteristics, intraoperative and delayed bleeding, perforation rates, and other adverse events were analyzed and compared between groups. Results: Baseline patient and lesion characteristics were comparable between the two groups. The mean procedure time was significantly shorter in the Spray coagulation group compared with the Swift coagulation group (42.2±23.7 vs 51.7±31.9 minutes, p<0.001). The mean number of hemostatic forceps applications was also significantly lower in the Spray group (1.53±2.00 vs 2.58±2.63, p<0.001). Intraoperative bleeding occurred more frequently in the Swift group, whereas rates of delayed bleeding, perforation, and local recurrence were low and did not differ significantly between groups. Conclusion: Both Swift and Spray coagulation modes can be safely used during colorectal ESD. However, Spray coagulation is associated with shorter procedure time and reduced intraoperative bleeding, suggesting practical advantages in technically demanding procedures. These findings, derived from a large single-center cohort, support the clinical relevance of coagulation mode selection. Prospective multicenter studies are warranted to confirm these results.

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Cite This Article

Baş, B., Küçükdemirci, Ö., Kandemir, A., Taşkıran, İ., Yaşa, M. H., Şahin, H., Çağı, M. E. (2026). Impact of swift versusspray coagulation on procedural outcomes in colorectal endoscopic submucosal dissection. Journal of Medicine and Palliative Care, Volume: 7 Issue: 2. https://doi.org/10.47582/jompac.1865761

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References (30)

  1. Gotoda T. Endoscopic resection of early gastric cancer. Gastric Cancer. 2007;10(1):1-11. doi:10.1007/s10120-006-0408-1
  2. Ono H, Kondo H, Gotoda T, et al. Endoscopic mucosal resection for treatment of early gastric cancer. Gut. 2001;48(2):225-229. doi:10.1136/gut.48.2.225
  3. Saito Y, Uraoka T, Yamaguchi Y, et al. A prospective, multicenter study of colorectal endoscopic submucosal dissection. Gastrointest Endosc. 2010;72(6):1217-1225. doi:10.1016/j.gie.2010.08.004
  4. Yamada M, Saito Y, Takamaru H, et al. Risk factors for perforation in colorectal endoscopic submucosal dissection. Endoscopy. 2014;46:476-482. doi:10.1055/s-0033-1351679
  5. Esaki M, Suzuki S, Hayashi Y, et al. Spray and forced coagulation mode endoscopic submucosal dissection for early gastric neoplasms: a multicenter randomized controlled trial. Am J Gastroenterol. 2025; 120(11):2538-2547. doi:10.14309/ajg.000000000000336
  6. Ishikawa Y, Goto O, Nakagome S, et al. Spray coagulation reduces the use of hemostatic forceps during gastric endoscopic submucosal dissection. JGH Open. 2024;8:e70002. doi:10.1002/jgh3.70002
  7. Maehara K, Esaki M, Sumida Y, et al. Comparison of hemostatic ability between spray coagulation and forced coagulation modes in endoscopic submucosal dissection: a multicenter randomized trial (Spray-G trial). Trials. 2024;25(1):53. doi:10.1186/s13063-023-07852-6
  8. Libânio D, Pimentel-Nunes P, Dinis-Ribeiro M. Endoscopic submucosal dissection: techniques and technology. Endoscopy. 2023;55(10):969-984. doi:10.1055/a-2031-0874
  9. Sakamoto T, Saito Y, Nakajima T, et al. Current status and future perspectives of colorectal endoscopic submucosal dissection. Gastrointest Endosc Clin N Am. 2023;33(1):89-105. doi:10.1016/j.giec. 2022.08.002
  10. Sakamoto T, Saito Y, Matsuda T, et al. Management of complications related to colorectal endoscopic submucosal dissection. Endoscopy. 2015;47:111-117. doi:10.1055/s-0034-1392935
  11. Yahagi N, Fujishiro M, Kakushima N, et al. The role of electrosurgical current in endoscopic submucosal dissection. Dig Endosc. 2009;21(Suppl 1):S7-S12. doi:10.1111/j.1443-1661.2009.00940.x
  12. Oyama T. Endoscopic submucosal dissection: devices and energy settings. Clin Endosc. 2012;45(4):375-378. doi:10.5946/ce.2012.45.4.375
  13. Toyonaga T, Man-i M, Fujita T, et al. The roles of different coagulation modes in endoscopic submucosal dissection. Dig Endosc. 2010;22:44-51. doi:10.1111/j.1443-1661.2009.00997.x
  14. Kato M, Takeuchi Y, Yamasaki Y, et al. Technical outcomes and complications of colorectal ESD. Gastrointest Endosc. 2016;84:76-86. doi:10.1016/j.gie.2016.02.010
  15. Tanaka S, Oka S, Kaneko I, et al. Endoscopic submucosal dissection for colorectal tumors: current status and future perspectives. Endoscopy. 2012;24(Suppl 1):73-79. doi:10.1111/j.1443-1661.2012.01252.x
  16. Saito Y, Yamada M, So E, et al. Colorectal endoscopic submucosal dissection: technical advantages compared with EMR. Gut. 2010;59:331-338. doi:10.1136/gut.2009.191436
  17. Probst A, Ebigbo A, Märkl B, et al. Endoscopic submucosal dissection for early colorectal neoplasia. Surg Endosc. 2017;31:2389-2396. doi:10.1515/iss-2017-0037
  18. Uraoka T, Parra-Blanco A, Yahagi N. Colorectal endoscopic submucosal dissection: is it suitable in Western countries? Gastrointest Endosc. 2013; 28(3):406-414. doi:10.1111/jgh.12099
  19. Repici A, Hassan C, De Paula Pessoa D, et al. ESD for colorectal lesions: a systematic review. Endoscopy. 2012;44(2):137-150. doi:10.1055/s-0031- 1291448
  20. Moss A, Bourke MJ, Williams SJ, et al. Endoscopic mucosal resection outcomes and recurrence. Gut. 2011;60:166-173. doi:10.1136/gut.2010. 223021
  21. Saito Y, Sakamoto T, Nakajima T. Colorectal ESD: indications and technique. Best Pract Res Clin Gastroenterol. 2017;31:441-452. doi:10. 1016/j.bpg.2017.09.002
  22. Yamasaki Y, Takeuchi Y, Uedo N, et al. Factors associated with prolonged procedure time in colorectal ESD. Endoscopy. 2017;49:1093-1100. doi:10.1055/s-0043-117884
  23. Sakamoto T, Matsuda T, Nakajima T, et al. Predictors of delayed bleeding after colorectal ESD. Gastrointest Endosc. 2016;83:129-137. doi: 10.1016/j.gie.2015.07.020
  24. Kakushima N, Fujishiro M. Endoscopic submucosal dissection for gastrointestinal neoplasms. World J Gastroenterol. 2008;14(19):2962-2967. doi:10.3748/wjg.14.2962
  25. Oyama T, Kikuchi Y. Aggressive endoscopic submucosal dissection for colorectal tumors. Dig Endosc. 2013;25(Suppl 1):52–57. doi:10.1111/den. 12139
  26. Saito Y, Hotta K, Imai K, et al. Clinical outcomes of colorectal ESD in Japan. Gastrointest Endosc. 2012;76:110-117. doi:10.1016/j.gie.2012.02.018
  27. Tamegai Y, Saito Y, Masaki N, et al. Endoscopic management of complications during colorectal ESD. Endoscopy. 2007;39:864-868. doi: 10.1055/s-2007-983701
  28. Yamaguchi Y, Saito Y, Takao T, et al. Long-term outcomes after colorectal ESD. Gastrointest Endosc. 2014;80:347-356. doi:10.1016/j.gie. 2014.04.010
  29. Probst A, Golger D, Anthuber M, et al. Colorectal ESD: risk factors for complications. Endoscopy. 2014;46:111-119. doi:10.1055/s-0033-1348837
  30. Pimentel-Nunes P, Libânio D, Bastiaansen BAJ, et al. Endoscopic submucosal dissection outcomes and future directions. Endoscopy. 2020;52:100-110. doi:10.1055/a-0958-5654