Intraluminal lavage to remove exfoliated tumor cells after colorectal endoscopic submucosal dissection

Inoue, Takashi; Fujii, Hisao; Koyama, Fumikazu; Nakamura, Shinji; Ueda, Takeshi; Nishigori, Naoto; Kawasaki, Keijiro; Obara, Shinsaku; Nakamoto, Takayuki; Uchimoto, Kazuaki; Morita, Kenichi; Nishikawa, Takeshi; Ohbayashi, Chiho; Nakajima, Yoshiyuki

doi:10.1007/s00464-015-4550-x

Cited by 17 publications

(16 citation statements)

References 15 publications

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“…4 Previous studies have shown that tumor cells exfoliate from CRC into the intestinal lumen, especially when the tumor is manipulated. 5,6 Yet, the risk of spontaneous tumor seeding, that is, implantation of tumor cells in damaged mucosa when polypectomy or biopsy is performed in the presence of CRC elsewhere in the colorectum, is estimated to be low. 7 However, the possibility of mechanical tumor seeding during colonoscopy, involving iatrogenic implantation of tumor cells in damaged mucosa, has never been explored.…”

Section: Background and Aimsmentioning

confidence: 99%

Tumor Seeding During Colonoscopy as a Possible Cause for Metachronous Colorectal Cancer

et al. 2019

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Section: Background and Aimsmentioning

confidence: 99%

Tumor Seeding During Colonoscopy as a Possible Cause for Metachronous Colorectal Cancer

et al. 2019

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“…It has been reported that tumor cells are exfoliated into the intestinal lumen during ESD 7 . After submucosal dissection, the ulcer bed is exposed to these exfoliated tumor cells for a long time during ESD, which can lead to TCI.…”

Section: Discussionmentioning

confidence: 99%

“…Intraluminal lavage with > 1000 mL fluid after ESD reportedly is useful for removing exfoliated tumor cells after colorectal ESD 7 . Use of this method may contribute to preventing TCI after ESD.…”

Section: Discussionmentioning

confidence: 99%

Recurrence of adenoma after curative endoscopic submucosal dissection for a rectal intramucosal adenocarcinoma in adenoma

et al. 2019

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Background and study aims A 71-year-old female underwent endoscopic submucosal dissection (ESD) for a subcircumferential lateral-spreading rectal tumor. Pathological examination showed an intramucosal adenocarcinoma in villous adenoma (size: 155 × 140 mm), which had been curatively resected with negative margins. However, follow-up colonoscopy revealed a tumor at the ulcer scar site, which soon grew into a circumferential lesion. Nineteen months after the first ESD procedure, additional ESD was performed for the recurrent lesion, which was resected en bloc without any adverse events, although severe fibrosis was noted in the submucosa. Pathological examination revealed a villous adenoma similar to the primary lesion with negative margins, but tumor cell nests were also present in the submucosa, which implied that tumor cell implantation had occurred during the first ESD. The post-ESD ulcer bed was subjected to argon plasma coagulation to prevent tumor recurrence after confirmation of the pathological results. There have not been any signs of recurrence during 9 years of follow-up.

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“…According to a meta-analysis, intraoperative rectal washout can reduce local recurrence after rectal cancer surgery [ 11 ]. Moreover, a recent study revealed that tumor cells can be exfoliated into the intestinal lumen during colorectal ESD [ 12 ], although little is known about the clinical significance of exfoliated tumor cells related to endoscopic procedures. Interestingly, a case report suggested that colorectal adenocarcinoma cells might be implanted into the artificial ulcer after endoscopic resection [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Unusual Local Recurrence with Distant Metastasis after Successful Endoscopic Submucosal Dissection for Colorectal Mucosal Cancer

Lee

Byeon

et al. 2017

Clin Endosc

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Intramucosal colorectal cancer (CRC) is thought not to metastasize because the colonic lamina propria lacks lymphatics. Only a few recent case reports have suggested lymph node metastasis from intramucosal CRC, but there is no clear evidence supporting the metastatic potential of intramucosal CRC. Hence, endoscopic resection is regarded as curative treatment for intramucosal CRC. This report describes two cases of unusual local recurrence with distant metastasis in patients who had previously undergone successful endoscopic submucosal dissection for intramucosal CRC. The recurrent colorectal lesions developed at the site of the previous endoscopic submucosal dissection scars in a relatively short-term period, and the pathologic findings showed an “undermining” invasion pattern without surrounding mucosal change. Based on the clinical course and pathological findings, we concluded that the second colorectal lesions were recurrences rather than de novo cancers.

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Intraluminal lavage to remove exfoliated tumor cells after colorectal endoscopic submucosal dissection

Cited by 17 publications

References 15 publications

Tumor Seeding During Colonoscopy as a Possible Cause for Metachronous Colorectal Cancer

Tumor Seeding During Colonoscopy as a Possible Cause for Metachronous Colorectal Cancer

Recurrence of adenoma after curative endoscopic submucosal dissection for a rectal intramucosal adenocarcinoma in adenoma

Unusual Local Recurrence with Distant Metastasis after Successful Endoscopic Submucosal Dissection for Colorectal Mucosal Cancer

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