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Retrospective study of technical aspects and complications of endoscopic submucosal dissection for large superficial colorectal tumors
Author(s) -
Nawata Yoshitaka,
Homma Kiyoaki,
Suzuki Yoshihiro
Publication year - 2014
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/den.12217
Subject(s) - medicine , perforation , endoscopic submucosal dissection , retrospective cohort study , dissection (medical) , surgery , nuclear medicine , radiology , materials science , punching , metallurgy
Background and Aim Colorectal endoscopic submucosal dissection ( ESD ) is widely carried out, but is still considered difficult. In 2010, a tumor size of ≥50 mm and less experience in colorectal ESD were reported as independent risk factors for complications such as perforation, delayed perforation and postoperative bleeding. In order to overcome such difficulties, we developed a scissors‐type grasping device and reported the treatment results of a multicenter study. The aim of the present study was to investigate therapeutic outcomes of colorectal ESD of different tumor sizes. Methods G roup A (134 tumors): tumor size <50 mm, and G roup B (16 tumors): tumors ≥50 mm. All tumors were removed by ESD . We retrospectively evaluated the clinicopathological features of the tumors and the treatment results. Results Age, sex, tumor location and histopathological diagnosis were not different between the two groups. Laterally spreading tumor non‐granular type was more often observed in G roup A (64/134, 47.8%) than in G roup B (0/16, 0%). Procedure time was significantly longer in G roup B ( G roup A : 38 min; G roup B : 86 min, P < 0.01). However, procedure speed was significantly faster in G roup B ( G roup A : 0.21 cm 2 /min; G roup B : 0.37 cm 2 /min, P < 0.01). No complications were observed in either group. The en bloc resection rate, en bloc R 0 resection rate, and en bloc curative resection rate were similar between the groups with no significant differences. Conclusions Procedure speed for G roup B was faster than that for G roup A . G roup B was treated as safely as G roup A .