Clinical utility of endoscopic submucosal dissection using the pocket-creation method with a HookKnife and preoperative evaluation by endoscopic ultrasonography for the treatment of rectal neuroendocrine tumors

2021 ◽  
Author(s):  
Yasuhiko Hamada ◽  
Kyosuke Tanaka ◽  
Aiji Hattori ◽  
Yuhei Umeda ◽  
Hiroki Yukimoto ◽  
...  
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Neuroendocrine Tumors ◽  
Endoscopic Ultrasonography ◽  
Clinical Utility ◽  
Preoperative Evaluation ◽  
Submucosal Dissection

scholarly journals Outcomes of Endoscopic Submucosal Dissection for Subepithelial Lesions Localized Within the Submucosa, Including Neuroendocrine Tumors: A Multicenter Prospective Study

2020 ◽  
Vol 29 (1) ◽  
pp. 41-49 ◽  
Author(s):  
Hideki Kobara ◽  
Yoichi Miyaoka ◽  
Yoshio Ikeda ◽  
Takayoshi Yamada ◽  
Masashi Takata ◽  
...  
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Neuroendocrine Tumors ◽  
Curative Resection ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
Submucosal Dissection ◽  
Organ Specific ◽  
Multicenter Prospective Study ◽  
Subepithelial Lesions

Background and Aims: Endoscopic submucosal dissection (ESD) seems to be a reasonable option for gastrointestinal subepithelial lesions (SELs) localized within the submucosa. Indications for ESD include small neuroendocrine tumors (NETs) and indeterminate SELs. However, the prospective data regarding ESD and surveillance remain unclear. This study was performed to prospectively investigate the outcomes of ESD, including organ-specific outcomes and the mid-term prognosis. Methods: This prospective multicenter study included 57 patients who underwent ESD for SELs localized within the submucosa [definite NETs (n = 42) and indeterminate SELs (n = 15)]. The efficacy and safety of ESD were evaluated in the whole cohort and in subgroups (NETs and indeterminate SELs). All patients were followed up. Results: The rates of en bloc resection, curative resection, and complications were 98.2%, 66.7%, and 7.7% for the overall population (n=57); 100%, 61.9%, and 2.4% for NETs (n=42); and 93.3%, 80.0%, and 20.0% for indeterminate SELs (n=15), respectively. The rates of curative resection for NETs were poorer in the stomach (20%, n=5) and duodenum (33%, n=3) than in the rectum (71%, n=34). Including 11 of 16 patients with NETs who underwent a conservative approach resulting in non-curative resection, no patients developed tumor recurrence during the follow-up period (median, 24.5 months; range, 1–60 months). ESD followed by surveillance demonstrated acceptable mid-term outcomes for non-curative NETs. Conclusions: ESD can be an efficient therapy for SELs localized within the submucosa. However, gastric and duodenal ESD for NETs may be limited in terms of its curative and technical aspects. Clinicians should be aware of the potential complications of ESD for indeterminate SELs.

The accuracy of endoscopic ultrasonography for identifying stomach neoplasm before endoscopic submucosal dissection.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 22-22
Author(s):  
Pil Hun Song ◽  
Hyun Sung ◽  
Jeonghun Lee ◽  
Won Jae Yoon ◽  
You Sun Kim ◽  
...  
Keyword(s):  
Lymph Node ◽  
Retrospective Study ◽  
Endoscopic Submucosal Dissection ◽  
Endoscopic Ultrasonography ◽  
Tumor Size ◽  
Stomach Neoplasm ◽  
Muscle Layer ◽  
Lymphatic Invasion ◽  
Submucosal Layer ◽  
Submucosal Dissection

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.

Endoscopic ultrasonography is valuable for identifying early gastric cancers meeting expanded-indication criteria for endoscopic submucosal dissection

2010 ◽  
Vol 25 (3) ◽  
pp. 841-848 ◽  
Author(s):  
Kazuhisa Okada ◽  
Junko Fujisaki ◽  
Akiyoshi Kasuga ◽  
Masami Omae ◽  
Kazuhito Yoshimoto ◽  
...  
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Endoscopic Ultrasonography ◽  
Gastric Cancers ◽  
Submucosal Dissection
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