Affiliation:
1. State Scientific Centre of coloproctology
Abstract
AIM: to assess results of endoscopic submucosal dissection (ESD) for colon neoplasms due to lesion site.PATIENTS AND METHODS: One-hundred thirteen patients (66 females, aged 65,7±11,0 years) with colon neoplasms which underwent ESD for one year (January 2017 – January 2018) were included in the study. All patients were divided in two groups depending on lesion site. The first group included patients with lesions in caecum, ascending colon and proximal third of tranverse colon, the second group – other colon parts and intraperitoneal part of the rectum. All patients underwent preoperative tests including colonoscopy, gastroscopy and transabdominal ultrasound. ESD included lesion marking, injection, circular incision and dissection. The results obtained were analyzed statistically using Graph Pad 7 for Mac. RESULTS: the 1st group included 61 (54.0%) patients and the 2nd – 52 (46.0%). Laterally spreading tumors (LST) were detected more often in the 1st group (56 patients of the 1st group vs 38 – in the 2nd, p=0.03). The lesion size in the 1st group was 31±13 (7-80) mm and 29±11 (8-76) in the 2nd one (p=0.3). Conversion from ESD to resection occurred in 9 (8.0%) patients, in 5 patients of the 1st group and in 4 – the 2nd one (p=1.0). The only reason for conversion was unfavorable lesion lifting (≤2 mm).Most of the lesions were removed en bloc, specimen fragmentation after ESD occurred in 10 (9.6%) patients: in 5 (9.0%) in the 1st group and in 5 (10.4%) in the 2nd (р=1.0). Intraoperative complications during ESD in the 1st group occurred in 2 (3.5%) cases and in 2 (4.1%) – in the 2nd (р=1.0). Postoperative complications were detected in 2 (1.9%) patients. Histopathology showed adenocarcinoma in 9 (8.0%) patients. Two (1.7%) patients produced local recurrence. CONCLUSION: ESD is a safe method removal of colon ademonas. The intra- and postoperative complications rate is 3.5% and 1.9% for the 1st and the 2nd group. Local recurrences occurred in 2,04%. Unfavorable lesion lifting (≤2 mm) in right colon is a risk factor for specimen fragmentation or conversion.
Publisher
Russian Association of Coloproctology
Reference18 articles.
1. Chernyshov SV, Maynovskaya OA, Rybakov EG. The results of 202 cases of transanal endomicrosurgery specialized center. Koloproktologia. 2015; no. 1 (51), pp. 91-91а. (in Russ.)
2. Shelygin YuA, Chernyshov SV, Peresada IV. The first experience of transanal endoscopic operations. Koloproktologia. 2012; no. 2 (40), pp. 34-40. (in Russ.)
3. Choi CW, Kang DH, Kim HW, Endoscopic submucosa ldissection as a treatment for gastric adenomatous polyps: predictive factors for early gastric cancer. Scand J Gastroenterol. 2012;47(10):1218-1225.
4. Isomoto H, Nishiyama H, Yamaguchi N. Clinicopathological factors associated with clinical outcomes of endoscopic submucosal dissection for colorectal epithelial neoplasms. Endoscopy. 2009;41(8):679-683. 5. Fujishiro M, Yahagi N, Kakushima N. Outcomes of endoscopic submucosal dissection for colorectal epithelial neoplasms in 200 consecutive cases. Clin Gastroenterol Hepatol. 2007;5:678-683.
5. Kanao H, Tanaka S, Oka S. Clinical significance of type V(I) pit pattern sub-classification in determining the depth of invasion of colorectal neoplasms. Gastroenterol. 2008;14:211-217.
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