The pocket-creation method facilitates colonic endoscopic submucosal dissection (with video)
| Autor: | Satoshi Shinozaki, Takahito Takezawa, Alan Kawarai Lefor, Keijiro Sunada, Yuichi Sagara, Yoshikazu Hayashi, Hironori Yamamoto, Hirotsugu Sakamoto, Yoshimasa Miura, Yasutoshi Kobayashi, Masahiro Okada |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Endoscope Databases Factual Endoscopic Mucosal Resection Operative Time Video Recording Negative margin Dissection (medical) Risk Assessment Lesion 03 medical and health sciences 0302 clinical medicine Chart review medicine Humans Radiology Nuclear Medicine and imaging Neoplasm Invasiveness R0 resection Aged Neoplasm Staging Retrospective Studies Analysis of Variance business.industry Dissection Gastroenterology En bloc resection Endoscopic submucosal dissection Colonoscopy Middle Aged medicine.disease Surgery Treatment Outcome Intestinal Perforation 030220 oncology & carcinogenesis Multivariate Analysis 030211 gastroenterology & hepatology Female medicine.symptom business Colorectal Neoplasms Follow-Up Studies |
| Zdroj: | Gastrointestinal endoscopy. 89(5) |
| ISSN: | 1097-6779 |
| Popis: | Colonic endoscopic submucosal dissection (ESD) is more difficult than rectal ESD because of poor maneuverability of the endoscope due to physiologic flexion, peristalsis, and respiratory movements. The aim of this study was to assess the usefulness of the pocket-creation method (PCM) for colonic ESD compared with the conventional method (CM) regardless of lesion shape or location.A total of 887 colorectal lesions were treated by ESD. Of 887 lesions, 271 rectal lesions, 72 lesions smaller than 20 mm in diameter, and 1 non-neoplastic lesion were excluded. This is a retrospective chart review of the remaining 543 colon lesions in 512 patients. We divided them into the PCM group (n = 280) and the CM group (n = 263). The primary outcome was the en bloc resection rate. Secondary outcomes were R0 resection (en bloc resection with negative margin), adverse events, dissection time (in minutes), and dissection speed (in mmThe PCM group achieved a significantly higher en bloc resection rate (PCM, 100% [280/280], vs CM, 96% [253/263]; P .001) and R0 resection rate (91% [255/280] vs 85% [224/263], respectively; P = .033) than the CM group. Dissection time was similar (69.5 ± 44.4 vs 78.7 ± 62.6 minutes, P = .676). Dissection speed was significantly faster with the PCM than with the CM (23.5 ± 11.6 vs 20.9 ± 13.6 mmColonic ESD using the PCM significantly improves the rates of en bloc resection and R0 resection and facilitates rapid dissection. |
| Databáze: | OpenAIRE |
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