Kenta Iguchi1, Hiroyuki Mushiake2, Toru Aoyama3, Hirokazu Suwa1, Norio Yukawa1, Mitsuyoshi Ota1, Yasushi Rino3, Chikara Kunisaki1, Itaru Endo4, Munetaka Masuda3. 1. Department of Surgery, Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan. 2. Department of Surgery, Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan mushiake@yokohama-cu.ac.jp. 3. Department of Surgery, School of Medicine, Yokohama City University, Yokohama, Japan. 4. Department of Gastroenterological Surgery, School of Medicine, Yokohama City University, Yokohama, Japan.
Abstract
BACKGROUND/AIM: The purpose of this study was to reveal the safety and efficacy of additional surgical resection (ASR) for high-risk T1 colorectal cancer (CRC) after endoscopic resection (ER). PATIENTS AND METHODS: We retrospectively analyzed 191 patients with high-risk T1 CRC after ER. RESULTS: The ASR was performed in 176 (92.1%) patients and 15 (7.9%) rejected ASR. All patients that underwent ASR experienced R0 resection; laparoscopic surgery was performed in 159 (90.3%) patients. Clavien-Dindo complications ≥grade II occurred in 33 patients (18.8%). Anastomotic leakage (8.5%) and ileus (5.7%) were the most frequent complications. The anus function was preserved in all patients. Metastatic lymph node was detected in 21 (11.9%) patients. There were no deaths or relapses in patients with ASR. One patient without ASR (6.7%) had a lymph node recurrence. CONCLUSION: ASR was safe and effective and is recommended for high-risk T1 CRC patients after ER. A satisfactory long-term outcome can be achieved. Copyright
BACKGROUND/AIM: The purpose of this study was to reveal the safety and efficacy of additional surgical resection (ASR) for high-risk T1 colorectal cancer (CRC) after endoscopic resection (ER). PATIENTS AND METHODS: We retrospectively analyzed 191 patients with high-risk T1 CRC after ER. RESULTS: The ASR was performed in 176 (92.1%) patients and 15 (7.9%) rejected ASR. All patients that underwent ASR experienced R0 resection; laparoscopic surgery was performed in 159 (90.3%) patients. Clavien-Dindo complications ≥grade II occurred in 33 patients (18.8%). Anastomotic leakage (8.5%) and ileus (5.7%) were the most frequent complications. The anus function was preserved in all patients. Metastatic lymph node was detected in 21 (11.9%) patients. There were no deaths or relapses in patients with ASR. One patient without ASR (6.7%) had a lymph node recurrence. CONCLUSION: ASR was safe and effective and is recommended for high-risk T1 CRCpatients after ER. A satisfactory long-term outcome can be achieved. Copyright
Authors: Nik Dekkers; Hao Dang; Jolein van der Kraan; Saskia le Cessie; Philip P Oldenburg; Jan W Schoones; Alexandra M J Langers; Monique E van Leerdam; Jeanin E van Hooft; Yara Backes; Katarina Levic; Alexander Meining; Giorgio M Saracco; Fabian A Holman; Koen C M J Peeters; Leon M G Moons; Pascal G Doornebosch; James C H Hardwick; Jurjen J Boonstra Journal: Surg Endosc Date: 2022-06-30 Impact factor: 4.584