João Santos-Antunes1, Francisco Baldaque-Silva1,2, Margarida Marques1, Joanne Lopes3, Fátima Carneiro3,4, Guilherme Macedo1. 1. Gastroenterology Department, Centro Hospitalar S. João, Porto, Portugal. 2. Department of upper GI Diseases, Unit of Gastrointestinal Endoscopy, Karolinska University Hospital, Stockholm, Sweden. 3. Pathology Department, Centro Hospitalar S. João, Porto, Portugal. 4. Ipatimup/i3S (Instituto de Investigação e Inovação em Saúde da Universidade do Porto), Porto, Portugal.
Abstract
BACKGROUND: Endoscopic submucosal dissection (ESD) enables accurate pathological evaluation and low recurrence rates. Large series describing ESD outcomes in Western countries are scarce. OBJECTIVE: To evaluate the real-life experience of ESD in a single Western centre. METHODS: Data of all the patients submitted to ESD in our centre were prospectively recorded in a database, from the first procedure in 2011 until May 2017. Feasibility, en bloc and R0 resection rates and safety were assessed. RESULTS: Three hundred and one ESDs were performed (37 in submucosal lesions) on 283 patients (54% male). Lesions were located in the oesophagus (n = 13), stomach (n = 169), duodenum (n = 4), colon (n = 35) and rectum (n = 80). ESD was technically successful in 292 lesions (97%); among malignant or premalignant epithelial lesions (n = 232), the en bloc resection rate was 91% and, of those, the R0 resection rate was 87% (between 69% in the colon and 93% in the stomach). Two patients needed surgery due to adverse events. Surgery for non-curative ESD was performed in 12 cases (58% without residual lesion). There were 10 perforations, 9 of them closed endoscopically. Mortality was 0%. CONCLUSION: Our real-life experience shows that ESD is feasible, safe and effective in Western settings.
BACKGROUND: Endoscopic submucosal dissection (ESD) enables accurate pathological evaluation and low recurrence rates. Large series describing ESD outcomes in Western countries are scarce. OBJECTIVE: To evaluate the real-life experience of ESD in a single Western centre. METHODS: Data of all the patients submitted to ESD in our centre were prospectively recorded in a database, from the first procedure in 2011 until May 2017. Feasibility, en bloc and R0 resection rates and safety were assessed. RESULTS: Three hundred and one ESDs were performed (37 in submucosal lesions) on 283 patients (54% male). Lesions were located in the oesophagus (n = 13), stomach (n = 169), duodenum (n = 4), colon (n = 35) and rectum (n = 80). ESD was technically successful in 292 lesions (97%); among malignant or premalignant epithelial lesions (n = 232), the en bloc resection rate was 91% and, of those, the R0 resection rate was 87% (between 69% in the colon and 93% in the stomach). Two patients needed surgery due to adverse events. Surgery for non-curative ESD was performed in 12 cases (58% without residual lesion). There were 10 perforations, 9 of them closed endoscopically. Mortality was 0%. CONCLUSION: Our real-life experience shows that ESD is feasible, safe and effective in Western settings.
Entities:
Keywords:
Endoscopic submucosal dissection; Western real-life experience
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