BACKGROUND AND STUDY AIMS: Endoscopic submucosal dissection (ESD) aims to resect large neoplastic lesions en bloc, allowing for more precise histopathological analysis. The present retrospective study aimed to analyze the technical and clinical outcomes after ESD of colorectal tumors. PATIENTS AND METHODS: ESD was performed for the treatment of 71 colorectal neoplasms in 70 patients (38 men, 32 women; mean age 63.4 years). Lesion size, procedure time, complications, and immediate and follow-up outcomes were evaluated. The results for these 71 lesions were compared with those for a group of 32 lesions treated by conventional piecemeal endoscopic mucosal resection (EMR) performed during the same period. RESULTS: For the ESD-treated group of lesions, the average lesion size was 32.7 mm (range 13-80 mm), and the mean operating time was 61.1 minutes (range 7-164 minutes). One perforation occurred in the ESD group (1.4%) and this was treated conservatively with clipping. The majority of these lesions (n = 50) were laterally spreading tumors. Histological examination showed low-grade adenoma in 12 cases; high-grade intraepithelial neoplasia in 47 cases; and submucosally invasive cancer in 11 cases, of which four were sm1, and seven were sm2 or sm3 (these seven patients underwent surgery). The en bloc resection rate was 98.6%. For the 64 tumors that were treated by radical endoscopic resection, no tumor recurrence was found after a mean follow-up period of 12.2 months (range 3-34 months) and a mean of 2.1 follow-up endoscopies (range 1-4). This contrasted with the 6.3% recurrence rate in the 32 piecemeal EMR cases (mean tumor size 28.7 mm, range 20-60 mm). CONCLUSION: In our hands, ESD is a safe and effective resection technique for large colorectal neoplasms. As experience with the technique increases, it might gradually replace piecemeal EMR in the majority of cases.
BACKGROUND AND STUDY AIMS: Endoscopic submucosal dissection (ESD) aims to resect large neoplastic lesions en bloc, allowing for more precise histopathological analysis. The present retrospective study aimed to analyze the technical and clinical outcomes after ESD of colorectal tumors. PATIENTS AND METHODS: ESD was performed for the treatment of 71 colorectal neoplasms in 70 patients (38 men, 32 women; mean age 63.4 years). Lesion size, procedure time, complications, and immediate and follow-up outcomes were evaluated. The results for these 71 lesions were compared with those for a group of 32 lesions treated by conventional piecemeal endoscopic mucosal resection (EMR) performed during the same period. RESULTS: For the ESD-treated group of lesions, the average lesion size was 32.7 mm (range 13-80 mm), and the mean operating time was 61.1 minutes (range 7-164 minutes). One perforation occurred in the ESD group (1.4%) and this was treated conservatively with clipping. The majority of these lesions (n = 50) were laterally spreading tumors. Histological examination showed low-grade adenoma in 12 cases; high-grade intraepithelial neoplasia in 47 cases; and submucosally invasive cancer in 11 cases, of which four were sm1, and seven were sm2 or sm3 (these seven patients underwent surgery). The en bloc resection rate was 98.6%. For the 64 tumors that were treated by radical endoscopic resection, no tumor recurrence was found after a mean follow-up period of 12.2 months (range 3-34 months) and a mean of 2.1 follow-up endoscopies (range 1-4). This contrasted with the 6.3% recurrence rate in the 32 piecemeal EMR cases (mean tumor size 28.7 mm, range 20-60 mm). CONCLUSION: In our hands, ESD is a safe and effective resection technique for large colorectal neoplasms. As experience with the technique increases, it might gradually replace piecemeal EMR in the majority of cases.
Authors: Sung Bum Cho; Wan Sik Lee; Young Eun Joo; Hyeng Rok Kim; Sang Wook Park; Chang Hwan Park; Hyeun Soo Kim; Sung Kyu Choi; Jong Sun Rew Journal: Surg Endosc Date: 2011-09-23 Impact factor: 4.584
Authors: Sergio Coda; Paolo Trentino; Fabio Antonellis; Barbara Porowska; Francesco Gossetti; Franco Ruberto; Francesco Pugliese; Giulia D'Amati; Paolo Negro; Takuji Gotoda Journal: Gastric Cancer Date: 2010-12-03 Impact factor: 7.370
Authors: Scott R Steele; Eric K Johnson; Bradley Champagne; Brad Davis; Sang Lee; David Rivadeneira; Howard Ross; Dana A Hayden; Justin A Maykel Journal: World J Gastroenterol Date: 2013-07-21 Impact factor: 5.742
Authors: F Bianco; A Arezzo; F Agresta; C Coco; R Faletti; Z Krivocapic; G Rotondano; G A Santoro; N Vettoretto; S De Franciscis; A Belli; G M Romano Journal: Tech Coloproctol Date: 2015-09-24 Impact factor: 3.781