Clinical Outcomes after En Bloc Resection of Periosteal Chondroma: A Retrospective Clinical Study

Abstract Background Although submucosal dissection is useful for treating laterally spreading colorectal tumors, there is little information regarding the endoscopic treatment of large protruding colorectal neoplasms. Here, we aimed to evaluate the clinical outcomes of endoscopic submucosal dissection for protruding colorectal neoplasms ≥ 20 mm in diameter. Methods In total, 112 consecutive patients undergoing treatment between January 2005 and June 2017 were enrolled retrospectively. The study period was divided into six periods to evaluate any changes in outcomes over time. We reviewed all short-term clinical outcomes, including lesion characteristics, procedure time, and percentages of en bloc resection, curative resection, adverse events, and treatment discontinuation. Results The percentages of en bloc, en bloc R0, and en bloc curative resections were 88 %, 82 %, and 59 %, respectively. Perforation occurred in 11 patients (10 %), and the endoscopic procedure was discontinued in five patients (4 %) because of technical difficulty. For lesions ≥ 40 mm in diameter, the procedure time showed a statistically significant decreasing trend in the latter half of the study period. However, the rate of cure did not improve along with enhancements to the procedure’s technological aspects. Conclusions Although endoscopic submucosal dissection for large protruding lesions has advanced in terms of its technical aspects, its ability to cure large protruding neoplasms has not shown gratifying results.

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Multi-loop traction device facilitates gastric endoscopic submucosal dissection: ex vivo pilot study and an inaugural clinical experience

BMC Gastroenterology ◽

10.1186/s12876-021-02085-w ◽

2022 ◽

Vol 22 (1) ◽

Author(s):

Hiroaki Matsui ◽

Naoto Tamai ◽

Toshiki Futakuchi ◽

Shunsuke Kamba ◽

Akira Dobashi ◽

...

Keyword(s):

Pilot Study ◽

Endoscopic Submucosal Dissection ◽

Clinical Outcomes ◽

Ex Vivo ◽

En Bloc Resection ◽

Bloc Resection ◽

R0 Resection ◽

En Bloc ◽

Submucosal Dissection ◽

Traction Device

Abstract Background Endoscopic submucosal dissection (ESD) is technically difficult and requires considerable training. The authors have developed a multi-loop traction device (MLTD), a new traction device that offers easy attachment and detachment. We aimed to evaluate the utility of MLTD in ESD. Methods This ex vivo pilot study was a prospective, block-randomized, comparative study of a porcine stomach model. Twenty-four lesions were assigned to a group that undertook ESD using the MLTD (M-ESD group) and a group that undertook conventional ESD (C-ESD group) to compare the speed of submucosal dissection. In addition, the data of consecutive 10 patients with eleven gastric lesions was collected using electronic medical records to clarify the inaugural clinical outcomes of gastric ESD using MLTD. Results The median (interquartile range) speed of submucosal dissection in the M-ESD and C-ESD groups were 141.5 (60.9–177.6) mm2/min and 35.5 (20.8–52.3) mm2/min, respectively; submucosal dissection was significantly faster in the M-ESD group (p < 0.05). The rate of en bloc resection and R0 resection was 100% in both groups, and there were no perforation in either group. The MLTD attachment time was 2.5 ± 0.9 min and the MLTD extraction time was 1.0 ± 1.1 min. Clinical outcomes of MLTD in gastric ESD were almost the same as those of ex vivo pilot study. Conclusions MLTD increased the speed of submucosal dissection in ESD and was similarly effective when used by expert and trainee endoscopists without perforation. MLTD can potentially ensure a safer and faster ESD.

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Clinical study of en bloc resection for squamous cell carcinoma of maxillary sinus

Toukeibu Gan ◽

10.5981/jjhnc.37.349 ◽

2011 ◽

Vol 37 (3) ◽

pp. 349-354

Author(s):

Hiroki Mitani ◽

Kazuyoshi Kawabata ◽

Hiroyuki Yonekawa ◽

Hirofumi Fukushima ◽

Tohru Sasaki ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Clinical Study ◽

Cell Carcinoma ◽

Maxillary Sinus ◽

Squamous Cell ◽

En Bloc Resection ◽

Bloc Resection ◽

En Bloc

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Clinical outcomes of early gastric cardiac cancer treated with endoscopic submucosal dissection in patients with different indications

10.21203/rs.3.rs-18393/v2 ◽

2020 ◽

Author(s):

Ting Fan ◽

Qi Sun ◽

Shouli Cao ◽

Xiangshan Fan ◽

Qin Huang ◽

...

Keyword(s):

Endoscopic Submucosal Dissection ◽

Clinical Outcomes ◽

En Bloc Resection ◽

Bloc Resection ◽

Resection Rate ◽

En Bloc ◽

Cardiac Cancer ◽

Submucosal Dissection ◽

Metastasis Rate

Abstract Background: Endoscopic submucosal dissection (ESD) has been accepted as a standard treatment for early gastric cardiac cancer (EGCC). Here, we investigate the clinical outcomes of the EGCC patients who underwent ESD in different indications. Methods: From January 2011 to October 2019, we enrolled 502 EGCC lesions from 495 patients which were resected by ESD at our center. We retrospectively analyzed the short-term and long-term clinical outcomes among different indication groups. Results: The number of the patients in the absolute indication (AI), expanded indication (EI) and beyond the expanded indication (BEI) groups was 265, 137 and 93, respectively. The en bloc resection rate was 100%, 100% and 98.9% ( P =0.185). The complete resection rate was 99.3%, 98.5% and 74.5%, respectively ( P <0.001). During a median follow-up of 48.1 months, the lymph node metastasis rate was 0%, 0% and 2.3% ( P <0.001). The distant metastasis rate was 0.4%, 0% and 2.3% ( P =0.150). The five-year disease-specific survival rate in the BEI group was 96.6% ( P =0.016), compared to 99.6% in the AI group and 100% in the EI group. Conclusion: The efficacy for ESD patients in EI group was almost equal to the AI group. Patients in the BEI group showed generally favorable clinical outcomes and needed to be carefully checked after ESD. ESD may be an optional treatment for patients unsuitable for gastrectomy.

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Clinical Outcomes of Endoscopic Submucosal Dissection for Early Esophageal Squamous Cell Neoplasms: A Retrospective Single-Center Study in China

Gastroenterology Research and Practice ◽

10.1155/2016/3741456 ◽

2016 ◽

Vol 2016 ◽

pp. 1-7 ◽

Cited By ~ 3

Author(s):

Yanfang Chen ◽

Ye Zhao ◽

Xiaojing Zhao ◽

Ruihua Shi

Keyword(s):

Clinical Outcomes ◽

Squamous Cell ◽

En Bloc Resection ◽

Bloc Resection ◽

Complete Resection ◽

Resection Rate ◽

En Bloc ◽

End Points ◽

Squamous Cell Neoplasms

Aims. To retrospectively analyze the clinical outcomes for a large number of endoscopic submucosal dissections (ESDs) in early esophageal squamous cell neoplasms (ESCNs) at the First Affiliated Hospital of Nanjing Medical University.Patients and Methods. From January 2010 to February 2014, 296 patients (mean age 61.4 years, range 31–85 years; 202 men) with 307 early ESCNs (79 intramucosal invasive esophageal squamous cell carcinomas (ESCCs) and 228 high-grade intraepithelial neoplasia (HGIN) cases) were included from a total of 519 consecutive patients who were treated by esophageal ESD at our hospital. The primary end points of the study were rates of en bloc resection and complete resection. Secondary end points were complications, residual and recurrence rates, and mortality during follow-up.Results. The en bloc resection rate and complete resection rate were 93.5% and 78.2%, respectively. Complications included strictures (8.4%), perforations (1.0%), and bleedings (0.7%). Twenty-seven (9.1%) patients experienced residual and 18 (6.1%) patients experienced recurrence during a mean follow-up period of 30 months. Thirteen patients died from causes unrelated to ESCC, and no cancer-related death was observed.Conclusions. Our study showed that ESD is a successful and relatively safe treatment for intramucosal invasive ESCC and HGIN, fulfilling the criteria of lymph node negative tumors. This should encourage clinicians to select ESD performed by experienced operators as a potential or even preferred treatment option for lesions amenable to endoscopic treatment.

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Clinical outcomes of early gastric cardiac cancer treated with endoscopic submucosal dissection in patients with different indications

10.21203/rs.3.rs-18393/v1 ◽

2020 ◽

Author(s):

Ting Fan ◽

Qi Sun ◽

Shouli Cao ◽

Xiangshan Fan ◽

Qin Huang ◽

...

Keyword(s):

Endoscopic Submucosal Dissection ◽

Clinical Outcomes ◽

En Bloc Resection ◽

Bloc Resection ◽

Resection Rate ◽

En Bloc ◽

Cardiac Cancer ◽

Submucosal Dissection ◽

Metastasis Rate

Abstract Background: Endoscopic submucosal dissection (ESD) has been accepted as a standard treatment for early gastric cardiac cancer (EGCC). Here, we investigate the clinical outcomes of the EGCC patients who underwent ESD in different indications. Methods: From January 2011 to October 2019, we enrolled 502 EGCC lesions from 495 patients which were resected by ESD at our center. We retrospectively analyzed the short-term and long-term clinical outcomes among different indication groups. Results: The number of the patients in the absolute indication (AI), expanded indication (EI) and beyond the expanded indication (BEI) groups was 265, 137 and 93, respectively. The en bloc resection rate was 100%, 100% and 98.9% ( P =0.185). The complete resection rate was 99.3%, 98.5% and 74.5%, respectively ( P <0.001). During a median follow-up of 48.1 months, the lymph node metastasis rate was 0%, 0% and 2.3% ( P <0.001). The distant metastasis rate was 0.4%, 0% and 2.3% ( P =0.150). The five-year disease-specific survival rate in the BEI group was 96.6% ( P =0.016), compared to 99.6% in the AI group and 100% in the EI group. Conclusion: The efficacy for ESD patients in EI group was almost equal to the AI group. Patients in the BEI group showed generally favorable clinical outcomes and needed to be carefully checked after ESD. ESD may be an optional treatment for patients unsuitable for gastrectomy.

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