Efficacy and safety of endoscopic resection techniques of large colorectal lesions: experience of a referral center in Italy
| Autor: | Silvia Pecere, G. Gibiino, Lucio Petruzziello, Ivo Boškoski, Federico Barbaro, Marco Napoli, Luigi Giovanni Papparella, Giorgia Burrelli Scotti, Guido Costamagna |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
endoscopic treatment Endoscopic Mucosal Resection Settore MED/12 - GASTROENTEROLOGIA Colonoscopy Endoscopic mucosal resection colorectal cancer medicine Retrospective analysis Humans Endoscopic resection Prospective Studies Submucosal dissection Intestinal Mucosa Referral and Consultation Retrospective Studies Hepatology medicine.diagnostic_test business.industry Significant difference Gastroenterology piecemeal resection Treatment Outcome Referral center Radiology Neoplasm Recurrence Local business Colorectal Neoplasms |
| Zdroj: | European journal of gastroenterologyhepatology. 34(4) |
| ISSN: | 1473-5687 |
| Popis: | Background Endoscopic mucosal resection and submucosal dissection (ESD) are treatments of choice for superficial neoplastic colorectal lesions. Only a few studies have compared these techniques. Aim To compare the efficacy and safety of endoscopic piecemeal mucosal resection (EPMR), ESD and hybrid-endoscopic submucosal dissection (H-ESD) of large colorectal lesions in a Western endoscopic center. Methods This is a retrospective analysis on a prospective medical database of consecutive colorectal superficial lesions larger than 20 mm, resected by EPMR, ESD or H-ESD collected from 2015 to 2019. Results Two hundred twenty-nine colorectal lesions were included. All lesions were completely endoscopically resected, 65.9% by EPMR, 19.7% by ESD and 14.4% by H-ESD. Endoscopic control after the index procedure was available for 86.5% patients. Among these patients, 80% had a second follow-up colonoscopy. The overall recurrence rate was 13.2, 0 and 6.1% for EPMR, ESD and H-ESD respectively, with a significant difference between EPMR and ESD. All recurrences were endoscopically treated during follow-up procedures. Risk of complications was not significantly different between the three groups. Conclusions EPMR, ESD and H-ESD are effective and safe procedures. Recurrence rate in EPMR was higher but can be managed endoscopically with high success rates. EPMR is faster and technically simpler so should be considered a potential first-line therapy for colorectal superficial neoplastic lesions. |
| Databáze: | OpenAIRE |
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