Real-World Experience of Endoscopic Submucosal Dissection for Ulcerative Colitis-Associated Neoplasia
| Autor: | Akira Matsui, Shu Hoteya, Junnosuke Hayasaka, Satoshi Yamashita, Yorinari Ochiai, Yugo Suzuki, Yumiko Fukuma, Takayuki Okamura, Yutaka Mitsunaga, Masami Tanaka, Kousuke Nomura, Nobuhiro Dan, Hiroyuki Odagiri, Daisuke Kikuchi |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: | |
| Zdroj: | Inflammatory Intestinal Diseases, Pp 1-8 (2021) |
| Druh dokumentu: | article |
| ISSN: | 2296-9403 2296-9365 |
| DOI: | 10.1159/000512292 |
| Popis: | Introduction: Patients with ulcerative colitis (UC) have an increased risk of colorectal cancer. Some studies have recently investigated endoscopic resection of UC-associated neoplasia (UCAN), but the indications for endoscopic resection of UCAN remain controversial. This study sought to clarify the problems encountered in endoscopic submucosal dissection (ESD) for UCAN. Methods: Seventeen lesions in 12 patients with UCAN (UCAN group) and 913 epithelial lesions in 824 control patients without UC (non-UC group) were evaluated. Both groups underwent ESD between January 2010 and December 2017 at Toranomon Hospital, Tokyo, Japan. Treatment outcomes of the 2 groups were compared retrospectively. Results: Univariate analysis showed that the mean tumor size was significantly smaller in the UCAN group than in the non-UC group (25.1 ± 26.7 mm vs. 31.9 ± 19.0; p = 0.0023); however, the R0 resection rate was significantly lower in the UCAN group (70.6 vs. 92.9%; p = 0.001). Multivariate analysis showed a significantly lower negative horizontal margin rate in the UCAN group (odds ratio 11.3, 95% confidence interval 3.588–34.525; p = 0.000). Discussion/Conclusion: ESD for UCAN is associated with a low-negative horizontal margin rate. When performing ESD for UCAN, it is important to evaluate the accuracy of the UCAN demarcation line, especially for flat lesions, using white-light imaging and chromoendoscopy as well as other modalities, including biopsy of surrounding tissues. |
| Databáze: | Directory of Open Access Journals |
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