Efficacy and Safety of Endoscopic Submucosal Dissection for Colorectal Carcinoids
| Autor: | Mei-Dong Xu, Ping-Hong Zhou, Shi-Lun Cai, Qiang Shi, Shiyao Chen, Li-Qing Yao, Yuan Ji, Tao Chen, Wei-Feng Chen, Yin-Yin Chen, Yun-Shi Zhong, Yi-Qun Zhang, Yan-Hong Xie |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male China medicine.medical_specialty Lymphovascular invasion Colonoscopy Endoscopic mucosal resection Carcinoid Tumor Metastasis Hospitals University Young Adult 03 medical and health sciences 0302 clinical medicine Recurrence medicine Humans Neoplasm Metastasis Risk factor Aged Retrospective Studies Hepatology medicine.diagnostic_test Histocytochemistry business.industry Gastroenterology Endoscopy Retrospective cohort study Endoscopic submucosal dissection Middle Aged medicine.disease Surgery Treatment Outcome 030220 oncology & carcinogenesis Female 030211 gastroenterology & hepatology Radiology Colorectal Neoplasms business Follow-Up Studies |
| Zdroj: | Clinical Gastroenterology and Hepatology. 14:575-581 |
| ISSN: | 1542-3565 |
| DOI: | 10.1016/j.cgh.2015.07.048 |
| Popis: | Although endoscopic submucosal dissection (ESD) of colorectal carcinoids is increasing, little is known about long-term outcomes of patients. We investigated the efficacy and safety of ESD of colorectal carcinoids and evaluated long-term outcomes, including local recurrence and metastasis.We performed a retrospective analysis of data collected from 239 consecutive patients with colorectal carcinoids20 mm who underwent endoscopic ultrasonography (to evaluate the size of tumor and the depth of invasion), followed by ESD from January 2007 through October 2012 at the Zhongshan Hospital of Fudan University. Histology and patient data were collected during a median follow-up period of 52 months (range, 25-94 months) to determine tumor stage and type, completeness of resection, complications, tumor recurrence, and distant metastasis.En bloc resection was achieved for all of the 239 treated lesions; tumor tissues were completely resected for 216 of the lesions (90.38%). Eight patients had ESD-related complications (3.35%). As more ESDs were performed by endoscopists, the rate of complete tumor resection increased, and the rate of complications decreased. ESD of carcinoids in colon increased the risk of non-R0 resection and the rate of complications. During the follow-up period, all patients remained free from local recurrence. However, distant metastases were detected in 6 patients (2.51%); lymphovascular invasion was a risk factor for metastasis.ESD is effective for the resection of rectal carcinoids20 mm and causes complications in less than 4% of patients. ESD for colonic carcinoids is feasible but associated with a higher non-R0 resection rate and a trend toward higher complications risk. Tumor features and stage determine risk for distant metastasis, so long-term follow-up is essential. |
| Databáze: | OpenAIRE |
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