Impact of technical innovations in EMR in the treatment of large nonpedunculated polyps involving the ileocecal valve (with video)

Vosko, Sergei; Shahidi, Neal; Hattem, W. Arnout van; Zahid, Simmi; McKay, Owen; Whitfield, Anthony; Sidhu, Mayenaaz; Tate, David J.; Lee, Eric Y.T.; Burgess, Nicholas G.; Bourke, Michael J.

doi:10.1016/j.gie.2021.05.011

Cited by 9 publications

(14 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Two large cohort studies have targeted conventional EMR of ICVL in Western countries. 5,6 Vosko et al reported a global, multicenter, retrospective cohort study that included 142 ICVL cases. The en-bloc resection and clinical success rates were 5.6% and 85.2%, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…They demonstrated that terminal ileum involvement and extensive ICV lip involvement were significant risk factors for clinical failure and recurrence. 5 Ponugoti et al reported a single-center, retrospective cohort study that included 118 ICVL cases. Of these, 90 cases were treated with endoscopic resection, and residual lesions were detected in 13 patients (16.5%) and 8 patients (18.6%) during the first surveillance and second surveillance, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Recurrence was observed in 13.5% of cases during the first surveillance. They demonstrated that terminal ileum involvement and extensive ICV lip involvement were significant risk factors for clinical failure and recurrence 5 . Ponugoti et al .…”

Section: Discussionmentioning

confidence: 99%

“…3 Some studies have investigated the outcomes of EMR for lesions involving the ileocecal valve (ICVL). [4][5][6] The initial endoscopic clearance by piecemeal EMR was good, but the recurrence observed during surveillance colonoscopy could not be disregarded. Moreover, in an Australian cohort, surgery was avoided in 81% of the patients.…”

Section: Introductionmentioning

confidence: 99%

“…The ICV and PAO are considered difficult sites for endoscopic tumor resection because of their complicated anatomical structures 3 . Some studies have investigated the outcomes of EMR for lesions involving the ileocecal valve (ICVL) 4–6 . The initial endoscopic clearance by piecemeal EMR was good, but the recurrence observed during surveillance colonoscopy could not be disregarded.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Feasibility of endoscopic submucosal dissection for cecal tumors involving the ileocecal valve or appendiceal orifice

Osera

Shinoki

Imai

et al. 2022

J of Gastro and Hepatol

View full text Add to dashboard Cite

Background and Aim Endoscopic resection of the ileocecal valve lesions (ICVL) and peri‐appendiceal orifice lesions (PAOL), is challenging. This study aimed to evaluate the feasibility of endoscopic submucosal dissection (ESD) for ICVLs and PAOLs compared with other cecal lesions (OCEL). Methods This was a multicenter, retrospective cohort study conducted at a cancer center hospital and two community hospitals. Non‐pedunculated cecal lesions that were intended to be treated by ESD followed by at least one surveillance colonoscopy were included. The main outcome was curative resection defined as en‐bloc resection and R0 resection without risk factors of metastases. The secondary outcome was co lon preservation. Results A total of 206 patients with 206 cecal lesions, including 37 ICVL, 27 PAOL, and 142 OCEL, who were to be treated with ESD were included in this study. Curative resection rates were 75.7% for ICVL, 70.4% for PAOL, and 77.5% for OCEL (P = 0.67). In the multivariate analysis of predictors of curative resection, tumor size (<40 mm) (odds ratio [OR] 2.40; 95% confidence intervals [CI], 1.14–5.04; P = 0.02) and a negative non‐lifting sign (OR 6.12; 95% CI, 2.55–14.60; P < 0.01) were significant. Colon preservation was achieved for 91.9% of the ICVL, 92.6% of the PAOL, and 90.8% of the OCEL (P = 0.947). Conclusions Based on curative resection and colon preservation rates, ESD was found to be feasible for ICVL and PAOL. Large tumor size (≥ 40 mm) and positive non‐lifting signs were significant factors for non‐curative resection.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%