Current research status of endoscopic submucosal dissection for colorectal neoplasms

Huang, Chen; Huang, Ruoyu; Xiang, Ping; Qiu, Zhengjun

doi:10.25011/cim.v35i4.17147

Cited by 13 publications

(5 citation statements)

References 48 publications

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“…Endoscopic submucosal dissection (ESD) may overcome this problem, allowing dissection of larger lesions in one piece. However, the procedure is technically difficult, time-consuming, associated with hospital admission and has an increased risk of complications such bleeding or perforation [11]. A recent review evaluating the efficacy of EMR and ESD for LSTs noted that overall polyp recurrence occurred more frequently with EMR (12.6%) compared to ESD (1.1 %).…”

Section: Introductionmentioning

confidence: 99%

Snare tip soft coagulation (STSC) after endoscopic mucosal resection (EMR) of large (> 20 mm) non pedunculated colorectal polyps: a systematic review and meta-analysis

et al. 2022

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Background and study aims Endoscopic mucosal resection (EMR) of laterally spreading tumors (LSTs) > 20 mm in size can be challenging. Piecemeal EMR of these lesions results in high rates of adenoma recurrence at first surveillance colonoscopy (SC1). Snare tip soft coagulation (STSC) of post resection margins is a safe and effective technique to prevent adenoma recurrence. We conducted a systematic review and meta-analysis to evaluate the effectiveness and safety of this technique. Patients and methods Multiple databases were searched through April 2021 for studies that reported on outcomes of post EMR STSC for LSTs > 20 mm in size. Meta-analysis was performed to determine pooled odds of adenoma recurrence as well as pooled proportion of adverse events including intraprocedural and delayed bleeding as well as intraprocedural perforation events. Results Six studies including two randomized controlled trials (RCT) and four cohort studies with 2122 patients were included in the final analysis. Overall pooled odds of adenoma recurrence at SC1 with post EMR STSC compared to no STSC was 0.27 (95 % 0.18–0.42; I2 = 0 %), P < 0.001. Pooled rate of adenoma recurrence at SC1 in post EMR STSC cohort was 6 %. Rates of intraprocedural bleeding, delayed bleeding and intraprocedural perforation were 10.3 %, 6.5 % and 2 % respectively. Conclusions Our results show that thermal ablation of resection margins with STSC in LSTs > 20 mm is a safe and effective technique in reducing the incidence of adenoma recurrence.

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Section: Introductionmentioning

confidence: 99%

Snare tip soft coagulation (STSC) after endoscopic mucosal resection (EMR) of large (> 20 mm) non pedunculated colorectal polyps: a systematic review and meta-analysis

et al. 2022

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“…In particular, because of the tenuity of the colorectal wall, colorectal ESD has a higher risk of perforation than gastric ESD. 30 Several studies reported perforation rates of 1.4-10.4% in colorectal ESD. 31 The majority of cases were treated successfully by conservative management without emergency surgery and small perforations were closed by endoscopic clipping.…”

Section: Discussionmentioning

confidence: 99%

Chronological Outcomes and Learning Curve of Endoscopic Submucosal Dissection for Colorectal Tumors

Lee

Kim

Park

et al. 2014

Korean J Gastroenterol

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Background/Aims: Endoscopic submucosal dissection (ESD) is an effective procedure for en-bloc curative resection of the colorectal tumor. As it requires high technical skills and experience in therapeutic endoscopy, it is important to understand learning curve of ESD technique. The aim of this study was to retrospectively describe the clinical results of ESD and to evaluate learning curve for the ESD of colorectal tumors. Methods: A total of 90 patients with 90 colorectal neoplasms, who had undergone ESD at a tertiary referral hospital from July 2009 to December 2012, were enrolled. The ESD was performed by a single endoscopist. All ESD cases were divided into three periods: first, cases 1-30; second, cases 31-60; and third, cases 61-90. Results: The en-bloc resection rates in third period (100%) was significantly higher than that of the first (93.3%) and second period (80%) (p=0.025). The perforation rate in third period (0%) also significantly decreased compared with that of the first (13.3%) and second period (20%) (p=0.032). To calibrate the difference of tumor size among periods, proficiency was calculated, as the procedure time per specimen area (min/cm 2 ). The proficiency in third period (4.3) was significantly shorter than that of the first (16.8) and second period (10.2) (p=0.004). Conclusions: The learning curve of colorectal ESD in our study shows that at least 60 cases of ESD have to be conducted to acquire sufficient skill of degree without perforation. (Korean J Gastroenterol 2014;64:198-205)

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“…inflammatory diseases such as ulcerative colitis; and non disseminated carcinoma that was not successfully removed after endoscopic mucosal resection (17). Regarding malignant lesions, mucosal neoplasms or carcinomas with superficial (< 1,000 μm) submucosal invasion without lymphovascular invasion are amenable to ESD as well (18,19).…”

Section: A B C D E Fmentioning

confidence: 99%

Endoscopic submucosal dissection in Spain: outcomes and development possibilities

Vila

Kutz²,

Fernández‐Esparrach

et al. 2013

Rev. esp. enferm. dig.

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Endoscopic submucosal dissection (ESD) allows endoscopic, curative, en-bloc resection of superficial malignant or premalignant lesions. This procedure was conceived over 10 years ago in Japan, but has not experienced great expansion in Western countries for different reasons. This article reviews ESD indications and outcomes, and reflects on the reasons that prevent ESD from becoming common clinical practice in Western hospitals. Finally, recommendations on ESD training in our setting are made.

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Current research status of endoscopic submucosal dissection for colorectal neoplasms

Cited by 13 publications

References 48 publications

Snare tip soft coagulation (STSC) after endoscopic mucosal resection (EMR) of large (> 20 mm) non pedunculated colorectal polyps: a systematic review and meta-analysis

Snare tip soft coagulation (STSC) after endoscopic mucosal resection (EMR) of large (> 20 mm) non pedunculated colorectal polyps: a systematic review and meta-analysis

Chronological Outcomes and Learning Curve of Endoscopic Submucosal Dissection for Colorectal Tumors

Endoscopic submucosal dissection in Spain: outcomes and development possibilities

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