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

Year 2026, Volume: 7 Issue: 2, 386 - 390, 27.03.2026

Berk Baş , Ömer Küçükdemirci , Altay Kandemir , İsmail Taşkıran , Mehmet Hadi Yaşa , Halil Şahin , Müge Erdem Çağı

https://izlik.org/JA53PT24UX

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.

Keywords

ESD , outcome , Spray , Swif

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