scholarly journals Feasibility of Endoscopic Resection for Sessile Nonampullary Duodenal Tumors: A Multicenter Retrospective Study

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Sung Min Park ◽  
Joo Ho Ham ◽  
Byung-Wook Kim ◽  
Joon Sung Kim ◽  
Chang Whan Kim ◽  
...  
Keyword(s):  
Endoscopic Resection ◽  
Medical Records ◽  
Complete Resection ◽  
Low Grade ◽  
High Grade ◽  
En Bloc ◽  
Endoscopic Intervention ◽  
Catholic University ◽  
Related Mortality ◽  
Demographic Features

Objectives. Sessile nonampullary duodenal tumors (SNADTs) are relatively rare and endoscopic resection of these lesions is considered more challenging than in other parts of the gastrointestinal tract. The aim of this study was to evaluate the feasibility of endoscopic resection for SNADT.Methods. Medical records including endoscopic resection for SNADT from July 2002 to July 2013 from 5 centers affiliated to The Catholic University of Korea were reviewed retrospectively. Demographic features and clinical outcomes such as complete resection and complications were analyzed.Results. A total of 56 lesions from 54 patients were enrolled in this study. Forty-five lesions were resected by endoscopic mucosal resection (EMR), 6 lesions by endoscopic submucosal dissection (ESD), and 5 lesions by simple polypectomy. Histologic examination after endoscopic resection revealed adenocarcinoma in 2, low grade adenoma in 25, high grade adenoma in 11, and carcinoid tumor in 18 lesions.En blocresection rates and histological complete resection rates were 78.6% (44/56) and 80.0% (28/35), respectively. Bleeding which required additional endoscopic intervention occurred in 1.8% (1/56) and perforation in 7.1% (4/56). There was no procedure-related mortality.Conclusions. Endoscopic resection techniques including ESD might be safe and effective modalities for the management of SNADT.

scholarly journals A133 GASTRIC ESD: PRELIMINARY EXPERIENCE IN A TERTIARY CENTER IN QUEBEC

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 117-118
Author(s):  
D Maillet ◽  
E Desilets ◽  
T Maniere
Keyword(s):  
Curative Resection ◽  
Residual Disease ◽  
High Grade Dysplasia ◽  
R0 Resection ◽  
Low Grade ◽  
High Grade ◽  
En Bloc ◽  
Delayed Bleeding ◽  
Tertiary Center ◽  
Intramucosal Adenocarcinoma

Abstract Background Endoscopic submucosal dissection (ESD) is an endoscopic procedure developed in Asian countries to treat early gastric cancer (EGC). Western countries have less experience with this challenging technique. Aims The goal of this study is to evaluate the effectiveness of ESD as a preliminary experience. Methods This is an unicentric retrospective study of all consecutive gastric ESD for adenomas or EGC from 07/2017 to 08/2020. The primary endpoints were en bloc and R0 resection rates. Results Nineteen patients (mean age 74.2 (54–88), sex ratio 3F/16M) and 23 lesions were included. Mean diameter was 25 mm (10–90). Treatment was previously performed in 7 cases (30.4%), by ESD (5) or EMR (2). The procedure, performed under general anaesthesia, lasted on average 148 minutes (45–412). En bloc resections were performed in 16 cases (69.6%); 5 cases (21.7%) were converted to P-EMR and there was a failure to resect the lesion because of deep invasion or perforation in 2 cases (8.7%). Pathologic examination demonstrated 2 low-grade dysplasia, 4 high-grade dysplasia and 15 adenocarcinomas: intramucosal (8), sm1 (2), sm2 (2), sm3 (1) or sm deep (2). R0 and curative resection rates were 43.5% and 39.1% respectively. The complication rate related to the procedure was 30.4% including 5 perforations and 2 delayed bleeding: all were managed endoscopically. Five patients (21.7%) underwent subsequent gastrectomy for non-curative resection (4) or failed resection (1); 3 had no residual disease on final pathology, 1 had high grade dysplasia and 1 had intramucosal adenocarcinoma. One patient went to palliative care because he was unfit for surgery. Follow-up endoscopy was completed in all 17 patients who underwent endoscopic resection (mean 10 months (2–24)). Recurrence occurred in 23.5% (4/17); all were successfully treated by another ESD. Conclusions In our preliminary experience, the rate of en bloc and R0 resection were 70% and 44%. Compared to other studies, these low en bloc and curative resection rates may be explained by technically difficult lesions during the learning curve and might improve with experience. Nevertheless, surgery has been avoided in 13/19 patients (68%) with endoscopic intervention. Funding Agencies None

Endoscopic resection of low grade, subglottic chondrosarcoma

2009 ◽  
Vol 123 (12) ◽  
pp. 1364-1366 ◽  
Author(s):  
Y Oestreicher-Kedem ◽  
T G Dray ◽  
E J Damrose
Keyword(s):  
Endoscopic Resection ◽  
Cricoid Cartilage ◽  
Voice Quality ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Low Grade ◽  
Retrospective Case ◽  
En Bloc ◽  
Extensive Resection ◽  
Airway Patency

AbstractIntroduction:This paper evaluates the feasibility of transoral, endoscopic resection of macroscopically localised, low grade, subglottic chondrosarcoma.Method:Retrospective case study including patients diagnosed with low grade, subglottic laryngeal chondrosarcoma. Tumours were resected endoscopically via direct laryngoscopy with microlaryngeal technique, under jet ventilation. The post-operative course, vocal fold function, airway patency and oncological results were evaluated.Results:Two male patients aged 49 and 60 years underwent endoscopic, translaryngeal, en bloc resection of low grade chondrosarcoma of the cricoid cartilage. Extubation was performed immediately after surgery. Neither patient required tracheostomy or developed subglottic stenosis. No tumour recurrence was noted after an average follow up of 10.5 months. Voice quality was stable and dyspnoea improved.Summary:Transoral, endoscopic resection of low grade, subglottic chondrosarcoma is a viable technique with good functional outcomes. Extensive resection of subglottic disease is possible, which may afford patients an alternative to total laryngectomy.

scholarly journals Submucosal Injection Solution for Endoscopic Resection in Gastrointestinal Tract: A Traditional and Network Meta-Analysis

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Zhang Yu Huai ◽  
Wei Feng Xian ◽  
Luo Chang Jiang ◽  
Wang Xi Chen
Keyword(s):  
Gastrointestinal Tract ◽  
Endoscopic Resection ◽  
Meta Analysis ◽  
Complete Resection ◽  
Analysis Method ◽  
Injection Solution ◽  
Resection Rate ◽  
En Bloc ◽  
Submucosal Injection ◽  
Complete Resection Rate

Objective. To explore and define the current optimal submucosal injection solution used in ESD and EMR for gastrointestinal tract neoplasms in terms of clinical outcomes and other aspects.Methods. PubMed, Cochrane Library, Embase, and clinical trials register center were searched with terms of “endoscopic resection” and “submucosal injection solution” to identify relevant randomized controlled trials (RCTs). Both direct comparison using traditional meta-analysis method and indirect comparison using network meta-analysis method were performed.Results. A total of 11 RCTs with 1152 patients were included. Meta-analysis showed that, compared with normal saline, other submucosal injection solutions induced a significant increase in terms ofen blocresection rate(I2=0%, OR = 2.11, 95% CI (1.36, 3.26), andP= 0.008)and complete resection rate(I2=0%, OR = 2.14, 95% CI (1.41, 3.24), andP= 0.0003); and there was no significant difference in the incidence of total complications(I2=0%, OR = 0.87, 95% CI (0.59, 1.29), andP= 0.49).Conclusions. Other newly developed submucosal injection solutions significantly increaseden blocresection rate and complete resection rate and decreased bleeding rate and finical cost of endoscopic resection in gastrointestinal tract, while current evidence did not find the difference between them, which need to be explored by further studies.

scholarly journals Successful Endoscopic Resection of Tubulovillous Adenoma Arising in Choledochocele

2021 ◽  
Vol 26 (1) ◽  
pp. 58-62
Author(s):  
Shin Hee Lee ◽  
Kyu-hyun Paik ◽  
Han Beol Jang ◽  
Jun Hyung Park ◽  
Jong Ok Kim ◽  
...  
Keyword(s):  
Malignant Transformation ◽  
Endoscopic Resection ◽  
Endoscopic Ultrasonography ◽  
Ampullary Carcinoma ◽  
Common Type ◽  
High Grade ◽  
Tubulovillous Adenoma ◽  
En Bloc ◽  
Endoscopic Papillectomy ◽  
Ampullary Tumor

Choledochocele is the least common type of choledochal cyst. Choledochocele has a potential for carcinogenesis, but only a handful of cases with concurrent ampullary carcinoma have been reported. We recently experienced a case of choledochocele with tubulovillous adenoma with focal high-grade dysplasia, which was successfully and completely resected en bloc via endoscopic papillectomy. Prior to endoscopic papillectomy, the endoscopic ultrasonography was able to accurately diagnose the ampullary tumor arising in choledochocele. Herein, we would like to report this case and discuss the potential of malignant transformation and the usefulness of endoscopic ultrasonography in choledochocele.

scholarly journals Pulmonary mucoepidermoid carcinoma: Clinicopathological characteristics of 20 cases and a literature review

2020 ◽  
Author(s):  
Jing Zhang ◽  
Yan Xiao Chen ◽  
Jun Zi Qian ◽  
Ping Yue ◽  
Jialei Wang ◽  
...  
Keyword(s):  
Tumor Markers ◽  
Medical Records ◽  
Mucoepidermoid Carcinoma ◽  
Clinicopathological Characteristics ◽  
Smoking History ◽  
Categorical Variables ◽  
Low Grade ◽  
High Grade ◽  
Alk Rearrangement ◽  
Ki 67

Abstract Background: Pulmonary mucoepidermoid carcinoma is a rare tumor of the lung. The clinicopathological characteristics of pulmonary mucoepidermoid carcinoma are not well defined due to the low incidence. This study was performed to provide more supplementary clues for the identification and understanding of pulmonary mucoepidermoid carcinoma. Methods: We reviewed the medical records since January 1, 2000 to December 31, 2018. The patients’ medical records，including age at the time of diagnosis , gender, smoking history, preoperative evaluations, operative procedures, tumor location, tumor size, tumor stage, lymph node metastasis, pathological markers, prognosis and survival information were extracted and reviewed. Categorical variables were presented as parameters and percentages. A comparison was performed between patients with high and low grade of pulmonary mucoepidermoid carcinoma. Results: 20 patients were identified and the age span is from 18 to 67 year-old with the average age is 45. Mucoepidermoid carcinomas were commonly found in men（60%）. 80% patients had clinical presentations and the positive rate of tumor markers was 78%, although no specific tumor markers were found. TTF-1 were negative in all cases. ALK rearrangement was identified in a non-smoking woman with high grade pulmonary mucoepidermoid carcinoma. Surgery is the main procedure. 3-year survival rate is 72% and 80% patients achieved disease-free alive. High-grade patients tend to harbor older age (p=0.035), larger tumor volume (p=0.026) and higher index of ki-67(p=0.0005). Conclusions: Pulmonary mucoepidermoid carcinoma could occur in a wide age span. Early diagnosis and complete surgical resection may promise a good prognosis. Grading is a key factor to predict the overall survival time. Combined TTF-1 and MAML2 will benefit the identification of pulmonary mucoepidermoid carcinoma from other lung tumors. Future prospective randomized controlled trials and larger, multi-centric series are needed.

scholarly journals Outcome of endoscopic resection of colonic polyps larger than 10 mm in patients with inflammatory bowel disease

2019 ◽  
Vol 07 (08) ◽  
pp. E994-E1001 ◽  
Author(s):  
Siddhant Yadav ◽  
Edward V. Loftus ◽  
W. Scott Harmsen ◽  
Louis M. Wong Kee Song ◽  
Nayantara Coelho-Prabhu
Keyword(s):  
Inflammatory Bowel Disease ◽  
Endoscopic Resection ◽  
Bowel Disease ◽  
Colonic Polyps ◽  
Published Data ◽  
Low Grade ◽  
Tubular Adenoma ◽  
En Bloc ◽  
Maximal Diameter ◽  
Inflammatory Bowel

Abstract Background and study aims There are limited published data on endoscopic removal of colorectal polyps by endoscopic mucosal resection (EMR) and endoscopic mucosal dissection (ESD) in patients with inflammatory bowel disease (IBD). Patients and methods We performed a retrospective review of patients with colonic IBD and colonic polyps >10mm who underwent EMR and/or ESD at our institution between January 1, 2012 and June 31, 2016. Results Ninety-seven patients with pathology-confirmed IBD (median disease duration 16 years) were included. Mild or moderate active colitis (in background biopsies) was seen in 85 %. Of the total 124 polyps, location was ascending colon in 44 %, transverse in 15 % and sigmoid in 18.5 %; of the total, 55 % were < 20 mm and 45 % were ≥20mm in maximal diameter. Using the Paris classification, 56 % of polyps were polypoid sessile (Is) polyps, while 38 % were non-polypoid (IIa, IIb, IIc). EMR was used in 118 polyps, three required ESD, and three by combined EMR-ESD. Seventy-two percent were resected en-bloc; 28 % underwent piecemeal resection. Histology included low-grade dysplasia in 75, serrated adenoma in 31, and tubular adenoma in 14 polyps. Chromoendoscopy was used in 33 (26.6 %). Adverse events occurred in three patients. Colectomy was performed in 11 patients within 12 months. Recurrence was seen in 20 polyps, 11 of which were successfully resected en-bloc using EMR. Polyps ≥ 20 mm and polyps treated with APC were found to have a statistically significantly higher risk of recurrence. Conclusion This study demonstrates the efficacy and safety of endoscopic resection of large polyps in patients with IBD, making them effective alternatives to colectomy.

scholarly journals Update on endoscopic treatment of Barrett’s oesophagus and Barrett’s oesophagus–related neoplasia

2020 ◽  
Vol 13 ◽  
pp. 263177452093524
Author(s):  
Oliver Pech ◽  
Saleh A. Alqahtani
Keyword(s):  
Radiofrequency Ablation ◽  
Endoscopic Resection ◽  
High Grade Dysplasia ◽  
Barrett’S Oesophagus ◽  
Low Grade ◽  
High Grade ◽  
Barrett's Oesophagus ◽  
Barrett’S Cancer ◽  
Visible Lesion ◽  
Low Grade Dysplasia

Endoscopic therapy of early Barrett’s oesophagus–related neoplasia is the treatment of choice for low-grade-dysplasia, high-grade dysplasia and mucosal Barrett’s cancer. Low-grade-dysplasia without any visible lesion should be ablated, preferably with radiofrequency ablation. In cases with the presence of a visible lesion, high-grade dysplasia and early Barrett’s adenocarcinoma, endoscopic resection techniques like multiband ligation endoscopic resection or endoscopic submucosal dissection should be applied. After complete resection of all visible neoplastic lesions, ablation of the remaining Barrett’s oesophagus should be performed to prevent recurrence. Ablation techniques available are radiofrequency ablation, argon plasma coagulation and cryoablation.

scholarly journals Endoscopic resections for superficial esophageal squamous cell epithelial neoplasia: focus on histological discrepancies between biopsy and resected specimens

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lang Yang ◽  
Hua Jin ◽  
Xiao-li Xie ◽  
Yang-tian Cao ◽  
Zhen-hua Liu ◽  
...  
Keyword(s):  
Endoscopic Resection ◽  
Squamous Cell ◽  
Medical Records ◽  
Intraepithelial Neoplasia ◽  
Lesion Size ◽  
Clinicopathological Parameters ◽  
Low Grade ◽  
Type B ◽  
Forceps Biopsy ◽  
Discrepancy Rate

Abstract Background Endoscopic resection has been used for high-grade intraepithelial neoplasia (HGIN) and superficial esophageal squamous cell carcinoma (ESCC) with limited risk of lymph node metastasis. However, some of these lesions cannot be accurately diagnosed based on forceps biopsy prior to treatment. In this study we aimed to investigate how to solve this histological discrepancy and avoid over- and under-treatment. Methods The medical records of patients with superficial esophageal squamous cell neoplasia who underwent endoscopic resection at our hospital from January 2012 to December 2019 were reviewed retrospectively. The histological discrepancy between the biopsy and resected specimens was calculated and its association with clinicopathological parameters was analyzed. Results A total of 137 lesions from 129 patients were included. The discrepancy rate between forceps biopsy and resected specimens was 45.3% (62/137). Histological discrepancy was associated with the histological category of the biopsy (p < 0.001). In addition, 17 of the 30 (56.7%) biopsies that was diagnosed as indefinite/negative for neoplasia or low-grade intraepithelial neoplasia were upgraded to HGIN or ESCC after resection. The upgrade was due to lesion size ≥ 10 mm (p = 0.002) and type B intrapapillary capillary loops (p < 0.001). Moreover, 34 of the 83 biopsies that were diagnosed with HGIN were upgraded to ESCC after resection, which was related to lesion size (p = 0.001), location (p = 0.018), and pink color sign (p = 0.002). Conclusions Histological discrepancy between forceps biopsy and resected specimens is common in clinical practice. Recognizing the risk factors for each histological category of biopsy may reduce these discrepancies and improve clinical management.

Efficacy and complications of submucosal tunneling endoscopic resection for upper gastrointestinal submucosal tumors and exploration for influencing factors

2018 ◽  
Vol 56 (04) ◽  
pp. 365-373 ◽  
Author(s):  
Shunzhe Song ◽  
Xu Wang ◽  
Shen Zhang ◽  
Yanxia Li ◽  
Xiaonan Zhang ◽  
...  
Keyword(s):  
Endoscopic Resection ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Complete Resection ◽  
Cochrane Library ◽  
En Bloc ◽  
Submucosal Tunneling Endoscopic Resection ◽  
Submucosal Tumors ◽  
Upper Gi ◽  
Upper Gastrointestinal

Abstract Background Submucosal tunneling endoscopic resection (STER) has emerged as a feasible technique for resecting upper gastrointestinal (GI) tract submucosal tumors (SMTs) through natural orifice transluminal endoscopic surgery. STER reduces the risk of postoperative perforation and abdominal infections and promotes rapid wound healing. The aim of this meta-analysis was to evaluate the safety and efficacy of STER for small (≤ 3.5 cm) upper GI SMTs and explore the potential factors influencing STER’s efficacy and complication rate. Methods Comprehensive literature searches were performed to find studies on STER for removal of SMTs. Several English-language databases were searched, including MEDLINE (through PubMed), EMBASE, and the Cochrane Library for the period January 2010 to June 2016. The medical terms “submucosal tunneling endoscopic resection or STER”, “upper gastrointestinal”, and “submucosal tumors” were used in the search. The primary outcome measures were the pooled estimates of the complete resection and en bloc resection rates. The secondary outcome measure was the pooled estimate of complications. Result Twelve studies including 397 patients and 430 lesions were identified. The pooled estimate of the complete resection rate was 98.1 % (95 % confidence interval [CI]: 95.9 – 99.2 %). The pooled estimate of en bloc resection was 94.9 % (95 % CI: 91.1 – 97.1 %). The pooled estimate of gas-related complications such as pneumoperitoneum and subcutaneous emphysema was 21.5 % (95 % CI: 13.2 – 33.1 %). The pooled estimate of inflammation-related complications including pleural and abdominal effusion was 8.4 % (95 % CI: 5.6 – 12.3 %). Gas-related complications occurred more frequently in the esophagogastric junction than in the stomach. In addition, the pooled estimate of delayed bleeding was 2.2 % (95 % CI: 1.0 – 4.7 %). Conclusion STER appeared to be an extremely effective technique for removing upper GI SMTs originating from the muscularis propria layer. In addition, the very low rate of complications also shows the safety of this technique. Tumor size, infiltration depth, and location may influence the complication rates.

Sign in / Sign up

Export Citation Format

Share Document