Predictors of incomplete resection and perforation associated with endoscopic submucosal dissection for colorectal tumors

Hayashi, Nana; Tanaka, Shinji; Nishiyama, S; Terasaki, Motomi; Nakadoi, Koichi; Oka, Shiro; Yoshihara, Masaharu; Chayama, Kazuaki

doi:10.1016/j.gie.2013.09.014

Cited by 145 publications

(159 citation statements)

References 35 publications

(48 reference statements)

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“…Poor endoscopic operability was also reported to be related with perforation (24). The rate of poor endoscopic operability was reported as 45.3%.…”

Section: Difficult Factors Of Colorectal Esdmentioning

confidence: 99%

“…Right-sided colon tumors, fibrosis, poor endoscopic operability and deep submucosal invasion are reported to be significantly associated with incomplete en bloc resection (6,24). We previously analyzed difficult factors of colorectal ESD using 405 consecutive colorectal ESD cases performed only by an expert in our institution (25) Table 2).…”

Section: Difficult Factors Of Colorectal Esdmentioning

confidence: 99%

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Tips for safety in endoscopic submucosal dissection for colorectal tumors

et al. 2017

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In Japan, endoscopic submucosal dissection (ESD) becomes one of standard therapies for large colorectal tumors. Recently, the efficacy of ESD has been reported all over the world. However, it is still difficult even for Japanese experts in some situations. Right-sided location, large tumor size, high degree of fibrosis, difficult manipulation is related with the difficulty. However, improvements on ESD devices, suitable strategies, and increase of operators' experiences enable us to solve these problems. In this chapter, we introduce recent topics about various difficult factors of colorectal ESD and the tips such as strategy, devices, injection, and traction method [Pocketcreation method (PCM) etc.].

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“…Poor endoscopic operability was also reported to be related with perforation (24). The rate of poor endoscopic operability was reported as 45.3%.…”

Section: Difficult Factors Of Colorectal Esdmentioning

confidence: 99%

Section: Difficult Factors Of Colorectal Esdmentioning

confidence: 99%

Tips for safety in endoscopic submucosal dissection for colorectal tumors

et al. 2017

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“…Factors such as large tumor size, laterally spreading tumors, tumor location (right-sided colon), submucosal injection without hyaluronic acid, severe fibrosis, and deep-submucosally invasive cancer were associated with a higher rate of perforation in other studies [8,10,20,21] . On the other hand, poor endoscopic operability was also reported to be related with perforation [22] . However, our study showed that difficult manipulation was not related with perforation during ESD.…”

mentioning

confidence: 99%

“…Commonly, endoscopic operability in colorectal ESD is due to many factors such as the operator's skill, breathing movement, heartbeat, and adhesion in the colorectum. Only one study reported detail analysis of poor endoscopic operability [22] . It defined poor endoscopic operability as the paradoxical movement of the endoscope, poor control for adhesion, and lesion movement with each heartbeat or breathing.…”

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confidence: 99%

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Difficult Manipulation is One of the Risk Factors for Incomplete Resection in Colorectal Endoscopic Submucosal Dissection

Yoshida

Fernandopulle

Murakami

et al. 2016

Journal of Gastroenterology and Hepatology Research

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AIM:Colorectal endoscopic submucosal dissection (ESD) remains a difficult procedure, even for experts. Difficult manipulation during procedure is one of the most important problems in colorectal ESD. In this study, we analyzed the risk factors for incomplete resection in colorectal ESD, focusing on difficult manipulation. MATERIALS AND METHODS:We retrospectively analyzed 405 consecutive tumors for which ESD was performed at the Kyoto Prefectural University of Medicine from 2010 to 2013 by a single expert endoscopist with extensive ESD experiences. The relationship between incomplete resection and clinicopathological factors were examined. Additionally, multivariate analysis was performed to examine risk factors of difficult manipulation. RESULTS:The rate of incomplete resection was 3.2%. The rates of severe fibrosis, difficult manipulation, and perforation were 10.8%, 23.5%, and 2.7%, respectively. Multivariate analyses showed that severe fibrosis (OR: 26.395, 95% CI: 6.587-105.764, p < 0.

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Endoscopic submucosal dissection for colorectal neoplasms: Risk factors for local recurrence and long‐term surveillance

et al. 2023

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ObjectivesEndoscopic submucosal dissection (ESD) is an effective procedure for the en bloc resection of colorectal neoplasms. However, risk factors for local recurrence after ESD have not been identified. This study aimed to evaluate such risk factors after ESD for colorectal neoplasms.MethodsThis retrospective study included 1344 patients with 1539 consecutive colorectal lesions who underwent ESD between September 2003 and December 2019. We investigated various factors associated with local recurrence in these patients. The main outcomes were the incidence of local recurrence and its relationship with clinicopathological factors during long‐term surveillance.ResultsThe en bloc resection rate was 98.6%, the R0 resection rate was 97.2%, and the histologically complete resection rate was 92.7%. Local recurrence was observed in 7/1344 (0.5%) patients and the median follow‐up period was 72 months (range 4–195 months). The incidence of local recurrence was significantly higher in lesions ≥40 mm in diameter (hazard ratio [HR] 15.68 [1.88–130.5]; p = 0.011), piecemeal resection (HR 48.42 [10.7–218.7]; p < 0.001), non‐R0 resection (HR 41.05 [9.025–186.7]; p < 0.001), histologically incomplete resection (HR 16.23 [3.627–72.63]; p<0.001), and severe fibrosis (F2; HR 9.523 [1.14–79.3]; p = 0.037).ConclusionsFive risk factors for local recurrence after ESD were identified. Patients with such factors should undergo careful surveillance colonoscopy.

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Predictors of incomplete resection and perforation associated with endoscopic submucosal dissection for colorectal tumors

Cited by 145 publications

References 35 publications

Tips for safety in endoscopic submucosal dissection for colorectal tumors

Tips for safety in endoscopic submucosal dissection for colorectal tumors

Difficult Manipulation is One of the Risk Factors for Incomplete Resection in Colorectal Endoscopic Submucosal Dissection

Endoscopic submucosal dissection for colorectal neoplasms: Risk factors for local recurrence and long‐term surveillance

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