A retrospective cohort study of factors influencing long procedure times in colorectal endoscopic submucosal dissection

Miyaguchi, Kazuya; Tashima, Tomoaki; Terada, Rie; Jinushi, Ryuhei; Nakano, Yasuaki; Katsuda, Hiromune; Ogawa, Tomoya; Fujita, Akashi; Tanisaka, Yuki; Mizuide, Masafumi; Mashimo, Yumi; Nakamoto, Hidetomo; Kawasaki, Tomonori; Imaeda, Hiroyuki; Ryozawa, Shomei

doi:10.1080/00365521.2021.1958000

Cited by 6 publications

(11 citation statements)

References 26 publications

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“…Multivariate analysis for long ESD time revealed significant differences in lesion size � 10 cm 2 and endoscopist's experience < 3 years (Table 5). Considering the ESD experience in Japan, lesion size was demonstrated as a factor related to longer procedure time, which is consistent with our results but not endoscopist's experience [17]. Miyaguchi et al compared experienced experts to trainees, while we compared the difference in ESD experience in the same group of endoscopists [17].…”

Section: Plos Onesupporting

confidence: 89%

“…We aimed to detect the influential factors of long procedure times. Although a study in Japan revealed fibrosis as a factor influencing long procedure times [17], there was no statistical significance in our study due to the limited cases of submucosal fibrosis. We, therefore, analyzed the possible factors, including location, size, and endoscopist's experience.…”

Section: Plos Onecontrasting

confidence: 87%

“…For the efficiency of colorectal ESD, there was no consensus on the length of ESD procedure time. Most of our ESDs were done within 100 minutes, and we considered the experience in Japan [17]. Thus, we defined a long procedure time as more than 100 minutes.…”

Section: Methodsmentioning

confidence: 99%

“…We searched ESD outcomes from different countries as references. According to a single-center study in Japan, the mean ESD time was 46.4 minutes for 1199 lesions [17]. A study conducted by a Singapore group showed a mean time of 80.9 minutes with a median lesion size of 19.3 mm, showing that larger lesions require longer procedure times [27].…”

Section: The Efficiency Of Esdmentioning

confidence: 99%

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Clinical outcomes of endoscopic submucosal dissection for colorectal neoplasms: A single-center experience in Southern Taiwan

Yao²,

Li³

et al. 2022

PLoS ONE

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Background and aims Endoscopic submucosal dissection (ESD) as an advanced endoscopic procedure can be considered for the removal of colorectal lesions with high suspicion of limited submucosal invasion or cannot be optimally removed by snare-based techniques. We aimed to analyze the clinical outcomes of ESD for colorectal neoplasms in our hospital. Methods We retrospectively enrolled 230 patients with 244 colorectal neoplasms who received ESD procedures from April 2012 to October 2020 at Kaohsiung Chang Gung Memorial Hospital. Clinicopathological data were collected by chart review. We also recorded ESD-related complications and clinical outcomes. Results The average age was 64 years old, with a mean follow-up time of 22.59 months. There was a loss of follow-up in 34 lesions. Most lesions were lateral spreading tumors of the non-granular type. The average ESD time was 51.9 minutes. Nine cases (3.7%) had procedure-related complications, including two intra-procedure perforations (0.8%) and seven delayed bleeding (2.9%) without procedure-related mortality. 241 lesions (98.8%) achieved en-bloc resection, while 207 lesions (84.8%) achieved R0 resection. Most lesions were tubulo-(villous) adenoma. Malignancy included 35 adenocarcinomas and 5 neuroendocrine tumors. No local recurrence was developed during follow-up. Multivariate analysis for long ESD time revealed significance in size ≥ 10 cm2 and endoscopist’s experience < 3 years. Pre-ESD endoscopic ultrasound revealed good prediction in discrimination of mucosal (sensitivity: 0.90) and submucosal lesion (specificity: 0.67). Conclusions ESD for colorectal neoplasms is an effective and safe technique. Size ≥ 10 cm2 and endoscopist’s experience < 3 years were significantly associated with long procedure time. Pre-ESD EUS provided a good prediction for colorectal neoplasms in invasion depth.

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Section: Plos Onesupporting

confidence: 89%

Section: Plos Onecontrasting

confidence: 87%

Section: Methodsmentioning

confidence: 99%

Section: The Efficiency Of Esdmentioning

confidence: 99%

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Clinical outcomes of endoscopic submucosal dissection for colorectal neoplasms: A single-center experience in Southern Taiwan

Yao²,

Li³

et al. 2022

PLoS ONE

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“…According to a single center in Japan, their mean ESD time was 46.4 minutes with 1199 lesions enrolled. [25] One study conducted by Singapore group showed mean time of 80.9 minutes with median lesion size of 19.3mm, which showed that larger lesions required a longer procedure time as well.…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes of colon endoscopic submucosal dissection for colonic neoplasms: A single center experience in South Taiwan

Yao

et al. 2022

Preprint

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The endoscopic submucosal dissection (ESD) is an advanced procedure for removal of colorectal lesions with highly suspicion of limited submucosal invasion or cannot be optimally removed by snare-based techniques. To analyze the clinical outcomes of colonic ESD, we retrospectively enrolled 230 patients with 244 colonic neoplasms, who received ESD procedure from April 2012 to October 2020 at Kaohsiung Chang Gung memorial hospital. The average age was 64 years old with mean follow-up times 22.59 months. 34 lesions were loss of follow-up. Most lesions were lateral spreading tumor with non-granular type. The average ESD time was 51.9 minutes. 9 cases had procedure-related complications, including 2 intra-procedure perforations and 7 delayed bleeding without procedure-related mortality. 241 lesions (98.8%) achieved En-bloc resection while 207 lesions (84.8%) achieved R0 resection. Most lesion was tubulo-(villous) adenoma. Malignancy included 35 adenocarcinoma and 5 NET. No local recurrence was developed during follow-up. Multivariate analysis for long ESD time revealed significance in size ≥ 10 cm2 and endoscopist experience < 3 years. Pre-ESD EUS revealed good prediction in discrimination of mucosal (Sensitivity: 0.90) and submucosal lesion (Specificity: 0.67).

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Factors influencing the prolonged duration of endoscopic submucosal dissection

Lu,

Lv,

Yang

2023

Gastrointestinal Endoscopy

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A retrospective cohort study of factors influencing long procedure times in colorectal endoscopic submucosal dissection

Cited by 6 publications

References 26 publications

Clinical outcomes of endoscopic submucosal dissection for colorectal neoplasms: A single-center experience in Southern Taiwan

Clinical outcomes of endoscopic submucosal dissection for colorectal neoplasms: A single-center experience in Southern Taiwan

Clinical outcomes of colon endoscopic submucosal dissection for colonic neoplasms: A single center experience in South Taiwan

Factors influencing the prolonged duration of endoscopic submucosal dissection

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