ESD with double clips and rubber band traction of neoplastic lesions developed in the appendiceal orifice is effective and safe
| Autor: | Romain Legros, Jérémie Jacques, Borathchakra Oung, Florian Rostain, Thierry Ponchon, Charles-Eric Ber, Edouard Chabrun, Florence Léger-Nguyen, Mathieu Pioche, Valérie Hervieu, Jean-Christophe Saurin, Jérôme Rivory, Julien Faller |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Original article business.product_category medicine.medical_treatment Traction system Lesion 03 medical and health sciences 0302 clinical medicine medicine Pharmacology (medical) lcsh:RC799-869 CLIPS computer.programming_language medicine.diagnostic_test business.industry Traction (orthopedics) Appendix Surgery Endoscopy medicine.anatomical_structure 030220 oncology & carcinogenesis Rubber band lcsh:Diseases of the digestive system. Gastroenterology 030211 gastroenterology & hepatology medicine.symptom business computer Body orifice |
| Zdroj: | Endoscopy International Open Endoscopy International Open, Vol 08, Iss 03, Pp E388-E395 (2020) |
| ISSN: | 2364-3722 |
| Popis: | Background and study aims Endoscopic submucosal dissection (ESD) of superficial colorectal lesions in close proximity to the appendiceal orifice (L-PAO) was shown to be feasible except in case of deep invasion into the appendix (type 3 of Toyonaga’s classification). This study aimed to determine the outcomes of ESD with double clip and rubber band traction (DCT-ESD) of L-PAO including a majority of type 3. Patients and methods We reviewed retrospectively all consecutive DCT-ESD of L-PAO performed in 3 French centers. Each lesion was described according to Toyonaga’s classification and type 0 lesions were excluded. The primary outcome was en bloc and R0 resection rates for L-PAO. Morbidity and salvage surgery were recorded. Results A total of 32 patients underwent DCT-ESD; 22 lesions (68.8 %) were type 3, including 11 with previous appendectomy (34.4 %). Median lesion size was 35 mm range (10–110 mm) and median duration of resection was 47 min range (10–230 min). We achieved 100 % of En bloc resection exclusively with DCT-ESD and 90.6 % of histological R0 resection rate. Per-procedure, 11 perforations occurred and were all immediately closed with clips. Overall, 3 patients (10.7 %) underwent surgery without stoma (2 complications related and 1 incomplete resection). No death occurred. Conclusion ESD of lesions deeply invading appendiceal orifice is feasible with the help of a traction system. Technical success by endoscopy avoiding surgery was achieved in 90.6 % of cases. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|