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Propensity score‐matched analysis of endoscopic resection for recurrent colorectal neoplasms: A pilot study
Author(s) -
Ohmori Masayasu,
Yamasaki Yasushi,
Iwagami Hiroyoshi,
Nakahira Hiroko,
Matsuura Noriko,
Shichijo Satoki,
Maekawa Akira,
Kanesaka Takashi,
Yamamoto Sachiko,
Higashino Koji,
Uedo Noriya,
Ishihara Ryu,
Okada Hiroyuki,
Takeuchi Yoji
Publication year - 2021
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.15519
Subject(s) - medicine , perforation , retrospective cohort study , surgery , propensity score matching , adverse effect , endoscopic mucosal resection , endoscopic submucosal dissection , resection , materials science , punching , metallurgy
Background and Aim Local residual/recurrent colorectal lesions after endoscopic resection (ER) are difficult to treat with conventional ER. Underwater endoscopic mucosal resection (UEMR) and endoscopic submucosal dissection (ESD) are reportedly effective. We investigated the appropriate indications of ESD and UEMR for recurrent colorectal lesions. Methods This single‐center, retrospective, observational study was conducted at a tertiary cancer institute. Patients who underwent UEMR or ESD for residual/recurrent colorectal lesions after ER from October 2013 to February 2019 were enrolled. Propensity score matching was performed between the UEMR and ESD groups to compare the clinical characteristics, treatment, and outcomes. Results In total, 30 UEMRs and 21 ESDs were performed. Median (range) diameter of the lesions was 8 mm (2–22 mm) in UEMR and 15 mm (2–58 mm) in ESD. Median procedure time in UEMR was significantly shorter than that of ESD (4 min [2–15 min] vs 70 min [17–193 min], P < 0.001). En bloc and complete resection rates of ESD were significantly higher than that of UEMR (73% vs 100%, 41% vs 81%, respectively). No adverse events occurred with UEMR, but there were two cases (10%) of delayed perforation with ESD. Neither group reported recurrence after treatment. Propensity score‐matched cases showed significantly shorter procedure time and hospitalization period in UEMR than in ESD. Conclusions The outcomes of UEMR and ESD were comparable. UEMR could be a useful salvage therapy for small local residual/recurrent colorectal lesions after ER with shorter procedure time and hospitalization period.