Jiale Zou1, Ningli Chai1, Enqiang Linghu2, Yaqi Zhai1, Zantao Wang1, Longsong Li1. 1. Department of Gastroenterology and Hepatology, The First Medical Center of PLA General Hospital, Beijing, 100853, China. 2. Department of Gastroenterology and Hepatology, The First Medical Center of PLA General Hospital, Beijing, 100853, China. linghuenqiang@vip.sina.com.
Abstract
BACKGROUND: Evidence that comprehensively compares the efficacy and safety of endoscopic submucosal tunnel dissection (ESTD) with endoscopic submucosal dissection (ESD) for rectal laterally spreading tumors (LSTs) is limited. METHODS: Between January 2009 and June 2018, 143 rectal LSTs in 143 patients who had undergone either ESD (n = 84) or ESTD (n = 59) were included in the study. One-to-one propensity score matching (PSM) was performed, and 50 pairs were selected. The data on patient demographics, treatment information, pathology reports, adverse events and follow-up were collected. RESULTS: Before PSM, the median specimen area was significantly larger in the ESTD group than in the ESD group (12.56 cm2 vs. 6.32 cm2, respectively; p < 0.001). The median dissection speed was significantly higher in the ESTD group than in the ESD group (24.53 mm2/min vs. 15.16 mm2/min, respectively; p < 0.001). After PSM, the median dissection speed was significantly higher in the ESTD group than in the ESD group (23.80 mm2/min vs. 17.12 mm2/min, respectively; p < 0.001). In multiple linear regression analysis, significant factors related to a higher dissection speed were the treatment method of ESTD (p < 0.001) and larger specimen area (p < 0.001). CONCLUSIONS: ESTD appears to be a safe and effective method to treat rectal LSTs. Compared with ESD, ESTD appears to achieve a higher dissection speed for rectal LSTs.
BACKGROUND: Evidence that comprehensively compares the efficacy and safety of endoscopic submucosal tunnel dissection (ESTD) with endoscopic submucosal dissection (ESD) for rectal laterally spreading tumors (LSTs) is limited. METHODS: Between January 2009 and June 2018, 143 rectal LSTs in 143 patients who had undergone either ESD (n = 84) or ESTD (n = 59) were included in the study. One-to-one propensity score matching (PSM) was performed, and 50 pairs were selected. The data on patient demographics, treatment information, pathology reports, adverse events and follow-up were collected. RESULTS: Before PSM, the median specimen area was significantly larger in the ESTD group than in the ESD group (12.56 cm2 vs. 6.32 cm2, respectively; p < 0.001). The median dissection speed was significantly higher in the ESTD group than in the ESD group (24.53 mm2/min vs. 15.16 mm2/min, respectively; p < 0.001). After PSM, the median dissection speed was significantly higher in the ESTD group than in the ESD group (23.80 mm2/min vs. 17.12 mm2/min, respectively; p < 0.001). In multiple linear regression analysis, significant factors related to a higher dissection speed were the treatment method of ESTD (p < 0.001) and larger specimen area (p < 0.001). CONCLUSIONS: ESTD appears to be a safe and effective method to treat rectal LSTs. Compared with ESD, ESTD appears to achieve a higher dissection speed for rectal LSTs.
Authors: Hyuk Soon Choi; Hoon Jai Chun; Min Ho Seo; Eun Sun Kim; Bora Keum; Yeon Seok Seo; Yoon Tae Jeen; Hong Sik Lee; Soon Ho Um; Chang Duck Kim; Ho Sang Ryu Journal: World J Gastroenterol Date: 2014-07-21 Impact factor: 5.742
Authors: Paolo Cecinato; Matteo Lucarini; Chiara Campanale; Francesco Azzolini; Fabio Bassi; Romano Sassatelli Journal: Endosc Int Open Date: 2022-09-14