Feasibility of endoscopic submucosal dissection for colorectal neoplasia at anastomotic sites: a retrospective study

2020 ◽  
Vol 34 (12) ◽  
pp. 5495-5500 ◽  
Author(s):  
Tadateru Maehata ◽  
Motohiko Kato ◽  
Yasutoshi Ochiai ◽  
Mari Mizutani ◽  
Koshiro Tsutsumi ◽  
...  
2018 ◽  
Vol 06 (11) ◽  
pp. E1340-E1348 ◽  
Author(s):  
Carl-Fredrik Rönnow ◽  
Noriya Uedo ◽  
Ervin Toth ◽  
Henrik Thorlacius

Abstract Background and study aims Endoscopic submucosal dissection (ESD) allows en bloc resection of large colorectal lesions but ESD experience is limited outside Asia. This study evaluated implementation of ESD in the treatment of colorectal neoplasia in a Western center. Patients and methods Three hundred and one cases of colorectal ESD (173 rectal and 128 colonic lesions) were retrospectively evaluated in terms of outcome, learning curve and complications. Results Median size was 4 cm (range 1 – 12.5). En bloc resection was achieved in 241 cases amounting to an en bloc resection rate of 80 %. R0 resection was accomplished in 207 cases (69 %), RX and R1 were attained in 83 (27 %) and 11 (4 %) cases, respectively. Median time was 98 min (range 10 – 588) and median proficiency was 7.2 cm2/h. Complications occurred in 24 patients (8 %) divided into 12 immediate perforations, five delayed perforations, one immediate bleeding and six delayed bleedings. Six patients (2 %), all with proximal lesions, had emergency surgery. Two hundred and four patients were followed up endoscopically and median follow-up time was 13 months (range 3 – 53) revealing seven recurrences (3 %). En bloc rate improved gradually from 60 % during the first period to 98 % during the last period. ESD proficiency significantly improved between the first study period (3.6 cm2/h) and the last study period (10.8 cm2/h). Conclusions This study represents the largest material on colorectal ESD in the west and shows that colorectal ESD can be implemented in clinical routine in western countries after appropriate training and achieve a high rate of en bloc and R0 resection with a concomitant low incidence of complications. ESD of proximal colonic lesions should be attempted with caution during the learning curve because of higher risk of complications.


Esophagus ◽  
2019 ◽  
Vol 16 (3) ◽  
pp. 258-263 ◽  
Author(s):  
Keitaro Takahashi ◽  
Mikihiro Fujiya ◽  
Nobuhiro Ueno ◽  
Takeshi Saito ◽  
Yuya Sugiyama ◽  
...  

2011 ◽  
Vol 26 (6) ◽  
pp. 1028-1033 ◽  
Author(s):  
Shinsuke Kiriyama ◽  
Yutaka Saito ◽  
Takahisa Matsuda ◽  
Takeshi Nakajima ◽  
Yumi Mashimo ◽  
...  

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 22-22
Author(s):  
Pil Hun Song ◽  
Hyun Sung ◽  
Jeonghun Lee ◽  
Won Jae Yoon ◽  
You Sun Kim ◽  
...  

22 Background: The treatment of stomach neoplasm was determined by the identification on of invasion extent and perigastric lymph node through endoscopic ultrasonography (EUS). In this study, we investigated diagnostic accuracy of EUS examination before endoscopic submucosal dissection (ESD). Methods: A retrospective study was conducted to both EUS and ESD for stomach neoplasms that were performed at Seoul Paik Hospital between January 2006 and July 2015. We compared the accuracy of EUS according to the location of lesion, tumor size and ulcer presence or absence on lesion. Results: 49 patients were enrolled in this study; their mean age was 64.14 ± 11.33 years. There were 40 male (81.6%) and 9 female (18.4%) patients. The cases of confined to the mucosa on pathology finding were 41 (83.6%) and involved to submucosal layer(sm) 1 were 3 (6.1%) and sm2 were 2 (4%) and sm3 were 1 (2%) and proper muscle layer were 2 (4%). The cases of lymphatic invasion were 2 (4%). The sensitivity and accuracy of antrum were 91.6 % (95% CI: 0.81-1.03) and 83.3 % (95% CI: 0.70-0.97), body of stomach were 92.3 % (CI: 0.78-1.07) and 83.3% (CI: 0.66-1.00), respectively. Whether lesions were no significant differences in any location. The tumor size was divided by smaller than 20 mm group, 20-30 mm group and more than 30 mm group. The smaller than 20 mm group, 20-30 mm group and more than 30 mm group were 36, 9, 2 patients. The remaining 2 patients were not described. The sensitivity and accuracy of smaller than 20 mm group were 96.6 % (95% CI: 0.90-1.03) and 83.3 % (CI: 0.71-0.95) and 2-30 mm group were 66.7 % (CI: 0.29-1.04) and 77.8 % (CI: 0.51-1.04), respectively. All patients were divided by ulcer presence or not. 27 patients were ulcer presence and 22 patients were not. The sensitivity and accuracy of ulcer presence group were 77.3 % (CI : 0.60-0.95) and 74 % (CI : 0.57-0.90), ulcer absence group were 95 % (CI : 0.85-1.04) and 91 % (CI : 0.79-1.02). Conclusions: The EUS for stomach neoplasm was reliable of lesion without ulcerous finding, smaller than 20 mm in diameter and irrespective of stomach neoplasm location.


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