Clinical outcomes of endoscopic submucosal dissection and endoscopic mucosal resection for laterally spreading tumors larger than 20 mm

Terasaki, Motomi; Tanaka, Shinji; Oka, Shiro; Nakadoi, Koichi; Takata, Sayaka; Kanao, Hiroyuki; Yoshida, Shigeto; Chayama, Kazuaki

doi:10.1111/j.1440-1746.2011.06977.x

Cited by 185 publications

(168 citation statements)

References 39 publications

Supporting

Mentioning

162

Contrasting

Order By: Relevance

“…On the basis of precise preoperative diagnosis with magnifying endoscopy, adenomatous lesions or focal carcinoma in adenomas C2 cm in diameter, for which en bloc snare EMR is not indicated, can be completely resected using deliberate piecemeal EMR to avoid segmentation of the carcinomatous area without compromising pathological diagnosis [2]. Although the local recurrence rate associated with piecemeal resection is high compared with that after en bloc resection [31,32,[47][48][49][50][51][52], most local recurrent lesions are adenomas. Cure is possible with additional endoscopic treatment for local recurrent intramucosal lesions [47,49,52,53].…”

Section: Cq In Which Types Of Colorectal Tumors Is It Acceptable To mentioning

confidence: 99%

Evidence-based clinical practice guidelines for management of colorectal polyps

et al. 2015

Self Cite

View full text Add to dashboard Cite

Background Recently in Japan, the morbidity of colorectal polyp has been increasing. As a result, a large number of cases of colorectal polyps that are diagnosed and treated using colonoscopy has now increased, and clinical guidelines are needed for endoscopic management and surveillance after treatment. Methods Three committees [the professional committee for making clinical questions (CQs) and statements by Japanese specialists, the expert panelist committee for rating statements by the modified Delphi method, and the evaluating committee by moderators] were organized. Ten specialists for colorectal polyp management extracted the specific clinical statements from articles published between 1983 and September 2011 obtained from PubMed and a secondary database, and developed the CQs and statements. Basically, statements were made according to the GRADE system. The expert panel individually rated the clinical statements using a modified Delphi approach, in which a clinical statement receiving a median score greater than seven on a nine-point scale from the panel was regarded as valid. Results The professional committee created 91CQs and statements for the current concept and diagnosis/treatment of various colorectal polyps including epidemiology, screening, pathophysiology, definition and classification, diagnosis, treatment/management, practical treatment, complications and surveillance after treatment, and other colorectal lesions (submucosal tumors, nonneoplastic polyps, polyposis, hereditary tumors, ulcerative colitis-associated tumor/carcinoma). Conclusions After evaluation by the moderators, evidence-based clinical guidelines for management of colorectal polyps have been proposed for 2014.

show abstract

Section: Cq In Which Types Of Colorectal Tumors Is It Acceptable To mentioning

confidence: 99%

Evidence-based clinical practice guidelines for management of colorectal polyps

et al. 2015

Self Cite

View full text Add to dashboard Cite

show abstract

“…Endoscopic submucosal dissection (ESD), which allows en bloc resection of flat or depressed colorectal tumors >20 mm, has recently been introduced and become a standard procedure in Japan [4][5][6] . In fact, many studies addressing the efficacy of ESD show that the rates of en bloc and curative resection are higher in patients treated with ESD than in those treated with EMR [7][8][9][10][11] . In contrast, the local recurrence rate was lower in patients treated with ESD than in those treated with EMR [7][8][9][10][11] .…”

Section: Introductionmentioning

confidence: 99%

“…In fact, many studies addressing the efficacy of ESD show that the rates of en bloc and curative resection are higher in patients treated with ESD than in those treated with EMR [7][8][9][10][11] . In contrast, the local recurrence rate was lower in patients treated with ESD than in those treated with EMR [7][8][9][10][11] . Thus, colorectal ESD has enabled the resection of large flat or depressed colorectal tumors as well as a wide variety of adenomas and early colorectal cancers.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Postoperative Bleeding in Endoscopic Submucosal Dissection of Colorectal Tumors

Okamoto¹,

Watanabe²,

Komeda³

et al. 2017

Oncology

View full text Add to dashboard Cite

antithrombotic therapy and rectal tumor location were strongly associated with POB following colorectal ESD. The incidence of POB was higher in patients on heparin bridge therapy (HBT) for the replacement of antithrombotic therapy than in patients with no HBT. Four of 7 patients (57.1%) on antithrombotic therapy experienced POB from the rectal lesions. Conclusion: Antithrombotic therapy and rectal lesions result in a higher POB incidence after colorectal ESD.

show abstract

“…ESD of colorectal tumors can provide clinical benefits as it enables en bloc resection of large superficial neoplasms (32,34). However, one of the problems with this procedure is the severe intraoperative and post-operative abdominal discomfort and distention caused by air infusion (15).…”

Section: Discussionmentioning

confidence: 99%

Carbon dioxide insufflation reduces residual gas in the gastrointestinal tract following colorectal endoscopic submucosal dissection

et al. 2018

View full text Add to dashboard Cite

Abstract. Quantitative examinations evaluating the effects of CO 2 insufflation on residual gas in the gastrointestinal tract following colorectal endoscopic submucosal dissection (ESD) are lacking. The present study aimed to assess whether CO 2 insufflation could decrease the amount of residual gas in the gastrointestinal tract following ESD in patients with colorectal neoplasms. Computed tomography (CT) was used to objectively examine whether CO 2 insufflation during colorectal ESD reduced residual gas levels in the gastrointestinal tract following ESD. A total of 83 patients who underwent colorectal ESD between January and December 2009 at Gifu University Hospital (Gifu, Japan) were enrolled. Following exclusion of 17 patients with chronic pulmonary dysfunction, 66 patients were randomized into a CO 2 insufflation group (n=34) and an air insufflation group (n=32). The level of residual gas and the presence of transmural and free-air leaks following ESD were evaluated in both groups using CT. Transcutaneous CO 2 tension (PtcCO 2 ) and ESD-related complications were also compared between the groups. CT measurements of the major and minor axes of the cecal lumen, and of the terminal ileum diameter, indicated the level of residual gas following ESD to be significantly reduced in the CO 2 insufflation group compared with the air insufflation group (P<0.001). Neither the incidences of ESD-related complications, including post-procedure hemorrhage and air leak, nor the abnormalities in vital signs differed between the groups. No significant between-group differences were identified in the baseline and peak PtcCO 2 levels during ESD or in the median PtcCO 2 following ESD. In conclusion, CO 2 insufflation during colorectal ESD was effective in reducing residual gas in the gastrointestinal tract following ESD. IntroductionColorectal cancer is among the most prevalent malignancies worldwide, and therefore effective and minimally invasive procedures are required to reduce the incidence rate of this malignancy (1,2). More recently, utilization of colorectal endoscopic submucosal dissection (ESD) as a minimally invasive treatment for en bloc resection of large superficial neoplasms has become a favored method (3). However, the risk of complication is higher than in gastric ESD as the wall of the colon is thin and operability is limited. In addition, colorectal ESD generally requires a long procedure time due to its technical difficulty (4,5). Therefore, a high level of gas enters the colonic lumen. This is associated with aggravation of subjective symptoms, such as abdominal pain, discomfort and distention, and an increased risk of severe problems, including pneumoderma, pneumothorax, abdominal compartment syndrome and air embolism (6)(7)(8)(9)(10)(11)(12)(13)(14).The safety and efficacy of CO 2 insufflation during ESD for lesions of the esophagus and stomach have been demonstrated in several randomized controlled trials (15-21). A pilot study also reported that CO 2 insufflation was safe and effective during colorectal ES...

show abstract

Clinical outcomes of endoscopic submucosal dissection and endoscopic mucosal resection for laterally spreading tumors larger than 20 mm

Cited by 185 publications

References 39 publications

Evidence-based clinical practice guidelines for management of colorectal polyps

Evidence-based clinical practice guidelines for management of colorectal polyps

Risk Factors for Postoperative Bleeding in Endoscopic Submucosal Dissection of Colorectal Tumors

Carbon dioxide insufflation reduces residual gas in the gastrointestinal tract following colorectal endoscopic submucosal dissection

Contact Info

Product

Resources

About