First experience of one and two-step endoscopic submucosal dissection of colorectal neoplasms
| Autor: | M V Panasyuk, I A Ivanov, L E Slavin, R N Khayrullin, I. M. Sayfutdinov, Anatoly I. Ivanov, R. T. Zimagulov, M S Mukharyamov, D I Sayfutdinova |
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| Rok vydání: | 2020 |
| Předmět: |
endoscopic submucosal dissection (esd)
Intraepithelial neoplasia medicine.medical_specialty one and two-step dissection Adenoma business.industry lcsh:R Perforation (oil well) Two step lcsh:Medicine Endoscopic mucosal resection General Medicine Endoscopic submucosal dissection colorectal neoplasms medicine.disease Surgery 03 medical and health sciences Dissection 0302 clinical medicine 030220 oncology & carcinogenesis medicine Diastasis 030211 gastroenterology & hepatology business |
| Zdroj: | Kazanskij Medicinskij Žurnal, Vol 101, Iss 3, Pp 446-451 (2020) |
| ISSN: | 2587-9359 0368-4814 |
| Popis: | Aim. To analyze the results of one and two-step endoscopic submucosal dissection in the treatment of colorectal neoplasms. Methods. Between 2018 and 2019, 17 patients (6 men and 11 women) aged 33 to 79 years underwent 21 endoscopic submucosal dissections of colorectal neoplasms ranging in size from 1.0 to 6.0 cm. Submucosal fibrosis was identified in 2 (11.8%) patients, epithelial neoplasms in 15 (88.2%) patients including laterally spreading tumors in 9 (60%), and large sessile colorectal polyps in 6 (40%) patients. Histological examination revealed a carcinoid tumor (11.8%), adenoma with low-grade (64.7%) and high-grade (23.5%) intraepithelial neoplasia. 13 patients were subjected to the one-step operation, and 4 patients required the two-step operation with a 1-day interval. Follow-up examinations after the operation were performed, on average, between 2 and 6 months. Results. En bloc endoscopic submucosal dissection was performed in 11 (64.7%) patients, 4 of them in combination with mucosal resection. Endoscopic piecemeal resection of the neoplasia was performed in 6 (35.3%) patients. The average operative time was 15573 minutes (range 40320 min). Intraoperative complications, which were eliminated endoscopically, occurred during 8 (38.1%) of 21 operations: intensive bleeding in 6 (75%) patients, diastasis of muscle fibers in 1 (12.5%) patient, perforation of the intestinal wall in 1 (12.5%) patient. At the follow-up at 6 months, all patients formed the scar at the surgical area, while 3 patients required endoscopic removal of residual adenoma 2 months after the operation. Conclusion. Endoscopic submucosal dissection is an effective method for removing colorectal neoplasms, while two-step dissection is a promising approach to the development of the technique.Keywords: one and two-step dissection, endoscopic submucosal dissection (ESD), colorectal neoplasms. |
| Databáze: | OpenAIRE |
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