Comparison of endoscopic submucosal dissection with laparoscopic-assisted colorectal surgery for early-stage colorectal cancer: a retrospective analysis

Background: Additional surgery is necessary in cases with non-curative endoscopic submucosal dissection. It is still unknown whether preceding endoscopic submucosal dissection (ESD) for T1 colorectal carcinoma affects the short outcomes of patients who underwent additional surgery or not as compared with surgery alone without ESD. Methods: Patients (101 pairs) with T1 colorectal cancer who underwent additional laparoscopic-assisted surgery after endoscopic submucosal dissection (additional surgery group, n = 101) or laparoscopic-assisted surgery alone (surgery alone group, n = 101) were matched (1:1). Short-term morbidity, operation outcomes, and lymph node metastasis of the resected specimen were compared. Results: There were no significant differences between the additional laparoscopic-assisted surgery and laparoscopic-assisted surgery alone groups in lymph node metastasis (9.9 vs. 5.9%, respectively, p = 0.297), operative time (147.76 ± 52.00 min vs. 156.50 ± 54.28 min, p = 0.205), first flatus time (3.56 ± 1.10 days vs. 3.63 ± 1.05 days, p = 0.282), first stool time (4.30 ± 1.04 days vs. 4.39 ± 1.22 days, p = 0.293), time to intake (5.00 ± 1.18 days vs. 5.25 ± 1.39 days, p = 0.079), blood loss (44.75 ± 45.40 mL vs. 60.40 ± 78.98 mL, p = 0.603), harvest lymph nodes (18.74 ± 7.22 vs. 20.32 ± 9.69, p = 0.438), postoperative surgical complications (p = 0.733), and postoperative length of hospital stay (8.68 ± 4.00 days vs. 8.39 ± 1.94 days, p = 0.401). Conclusion: ESD did not increase the difficulty of additional laparoscopic-assisted surgery, hospital stay, or the incidence of postoperative complications. Additional laparoscopic-assisted surgery is safe and recommended for patients with T1 cancer at high risk of lymph node metastasis and residual cancer after non-curative ESD.

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A Novel Opportunity in Minimally Invasive Colorectal Cancer Therapy: Defining a Role for Endoscopic Submucosal Dissection in the United States

Diagnostic and Therapeutic Endoscopy ◽

10.1155/2013/681783 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 3

Author(s):

Jonah Cohen

Keyword(s):

Colorectal Cancer ◽

United States ◽

Minimally Invasive ◽

Endoscopic Submucosal Dissection ◽

Early Stage ◽

The United States ◽

Histological Evaluation ◽

Gastrointestinal Neoplasms ◽

En Bloc ◽

Submucosal Dissection

Colorectal cancer is the third most common cancer among both men and women in the United States and the second leading cause of cancer death. Endoscopic submucosal dissection (ESD) is an innovative advanced endoscopic therapy for superficial gastrointestinal neoplasms which is rapidly becoming standard of care particularly in Asia. ESD was first developed for the resection of early gastric cancers; yet ESD for colon tumors has gained increasing attention in recent years. The advantage of ESD over conventional endoscopic resection lies in its potential to achieve en bloc resection regardless of tumor size, leading to more precise histological evaluation and greater potential for cure. Selecting appropriate patients for this procedure involves identifying colorectal cancers with nul risk of lymph node spread. For colorectal ESD to engraft in the United States, the prevalence of such early stage lesions must be defined so that centers of excellence can be developed for high volume clinical practice to offer patients the safest and most efficacious outcomes. This review discusses the endoscopic staging of colorectal neoplasms, indications for colorectal ESD, and the epidemiology of early stage ESD-amenable colorectal cancer in America to better define an opportunity for this important minimally invasive therapy.

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Sa1509 A Prospective Questionnaire Study of Quality of Life After Colorectal Endoscopic Submucosal Dissection Compared With Laparoscopy-Assisted Colectomy for Early Stage Colorectal Cancer

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2013.03.560 ◽

2013 ◽

Vol 77 (5) ◽

pp. AB231-AB232

Author(s):

Shin Haruyama ◽

Fumihiko Nakamura ◽

Masayoshi Yamada ◽

Eriko so ◽

Taku Sakamoto ◽

...

Keyword(s):

Quality Of Life ◽

Colorectal Cancer ◽

Endoscopic Submucosal Dissection ◽

Early Stage ◽

Questionnaire Study ◽

Submucosal Dissection ◽

Colorectal Endoscopic Submucosal Dissection

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Cost Analysis of Endoscopic Submucosal Dissection for the Treatment of Colorectal Lesions in China

BioMed Research International ◽

10.1155/2019/6983896 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7

Author(s):

Ning Cui ◽

Yu Zhao ◽

Honggang Yu

Keyword(s):

Colorectal Cancer ◽

Cost Analysis ◽

Endoscopic Submucosal Dissection ◽

Transverse Colon ◽

Surgical Margin ◽

Positive Surgical Margin ◽

Labor Costs ◽

Positive Surgical Margins ◽

Submucosal Dissection ◽

Treatment Medication

Aim. The aim of the study was to evaluate costs associated with colonic endoscopic submucosal dissection (ESD) for treatment of colorectal cancer. Methods. The study is a retrospective analysis of data on 395 patients treated by colonic ESD. Results. The operation, consumable items, and medication accounted for 71% of the total costs for colonic ESD treatment. Medication and consumable items’ costs were higher if lesions occurred in the transverse colon and right hemicolon compared to the left hemicolon. Medication, consumable items, and total costs were higher for larger lesions. Lesion numbers and carcinoma were associated with higher medication, consumable items, operation, and total costs. Positive surgical margins and complications of hemorrhage or perforation were positively correlated with higher costs for medication, consumable items, and total costs. Conclusion. Labor costs for doctors and nurses remain low in China. Costs for medication and consumable items were higher for treatment involving the transverse colon or right hemicolon (vs. the left hemicolon), larger lesions, carcinoma, and a positive surgical margin. A benchmark cost estimate for ESD treatment including 4 days of postoperative hospitalization was determined to be approximately 5400 USD.

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