| Autor: |
Fabio S. Kawaguti, Cintia Mayumi Sakurai Kimura, Renata Nobre Moura, Adriana Vaz Safatle-Ribeiro, Caio Sergio Rizkallah Nahas, Carlos Frederico Sparapan Marques, Daniel Tavares de Rezende, Vanderlei Segatelli, Guilherme Cutait de Castro Cotti, Ulysses Ribeiro-Junior, Fauze Maluf-Filho, Sergio Carlos Nahas |
| Rok vydání: |
2022 |
| Předmět: |
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| Zdroj: |
Diseases of the Colon & Rectum. |
| ISSN: |
0012-3706 |
| DOI: |
10.1097/dcr.0000000000002554 |
| Popis: |
Recent data show an increasing number of abdominal surgeries being performed for the treatment of nonmalignant colorectal polyps in the West but in settings where colorectal endoscopic submucosal dissection is not routinely performed. This study evaluated the number of nonmalignant colorectal lesions referred to surgical treatment in a tertiary cancer center that incorporated magnification chromoendoscopy and endoscopic submucosal dissection as part of the standard management of complex colorectal polyps.The study aimed to estimate the number of patients with nonmalignant colorectal lesions referred to surgical resection at our institution after the standardization of routine endoscopic submucosal dissection and to describe outcomes for patients undergoing colorectal endoscopic submucosal dissection.Single-center retrospective study from prospectively collected database of endoscopic submucosal dissections and colorectal surgeries performed between January 2016 and December 2019.Reference cancer center.Consecutive adult patients with complex nonmalignant colorectal polyps.Patients with nonmalignant colorectal polyps treated by endoscopic submucosal dissection or surgery (elective colectomy, rectosigmoidectomy, low anterior resection, or proctocolectomy).The primary outcome measure was the percentage of patients referred to colorectal surgery for non-malignant lesions.In the period, 1.1% of 825 colorectal surgeries were performed for nonmalignant lesions, and 97 complex polyps were endoscopically removed by endoscopic submucosal dissection. The en bloc, R0, and curative resection rates of endoscopic submucosal dissection were 91.7%, 83.5%, and 81.4%, respectively. The mean tumor size was 59 (SD 37.8) mm. Perforations during endoscopic submucosal dissection occurred in 3 cases, all treated with clipping. One patient presented with a delayed perforation 2 days after the endoscopic resection and underwent surgery. The mean follow-up period was 3 years, with no tumor recurrence in this cohort.Single-center retrospective study.A workflow that includes assessment of the lesions with magnification chromoendoscopy and resection through endoscopic submucosal dissection can lead to a very low rate of abdominal surgery for nonmalignant colorectal lesions. See Video Abstract at http://links.lww.com/DCR/C123. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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