Technical difficulty according to location, and risk factors for perforation, in endoscopic submucosal dissection of colorectal tumors

Mizushima, Takeshi; Kato, Mototsugu; Iwanaga, Ichiro; Sato, Fumiyuki; Kubo, Kimitoshi; Ehira, Nobuyuki; Uebayashi, Minoru; Ono, Shouko; Nakagawa, Manabu; Mabe, Katsuhiro; Shimizu, Yuichi; Sakamoto, Naoya

doi:10.1007/s00464-014-3665-9

Cited by 87 publications

(81 citation statements)

References 23 publications

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“…In our study, we looked at large tumors (>10 cm 2 ) and found that tumor size was technically demanding for perforation, which is consistent with what was observed in previous studies (14)(15)(16). However, a recent study found that when ESD were performed before 2010, tumor size might be technically demanding for perforation, but when ESD was performed after 2010 in the same institution, the results were different (11). Our data were collected from the beginning of performing CR-ESD; therefore, a performance learning curve must be considered.…”

Section: Discussionsupporting

confidence: 87%

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Predictive factors for technically difficult endoscopic submucosal dissection in large colorectal tumors

He¹,

Wang²,

Du³

et al. 2016

Turk J Gastroenterol

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Section: Discussionsupporting

confidence: 87%

“…Mizushima et al (11) reported technically difficult ESD based on location, and their analysis suggested that sigmoid colon was more technical demanding for CR-ESD. However, there have been no reports that describe risk factors for technical difficulty of large-sized CR-ESD.…”

Section: Discussionmentioning

confidence: 99%

Predictive factors for technically difficult endoscopic submucosal dissection in large colorectal tumors

He¹,

Wang²,

Du³

et al. 2016

Turk J Gastroenterol

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“…Inappropriate EMR with uncertain resected locations might deteriorate patients’ quality of life. When it comes to the lesion over 20 mm performed en bloc resection by ESD, the location of the resected site is clear [17-21]. …”

Section: Discussionmentioning

confidence: 99%

One-to-One Correspondence Locations of Resected Polyps after Endoscopic Resection Using Catcher Tagged Method: A Randomized Prospective Study

et al. 2017

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Background/Aims: Multiple colorectal polyps with a diameter in the range of 10–19 mm are unable to be retrieved through a 3-mm endoscopic channel by the aspiration method. This study aims to assess the usefulness of Catcher Tag retrieval, which not only allows the accurate identification of the resected location but also enables the easiest retrieval in a short time without any special device. Methods: One hundred thirty five patients (483 polyps) were diagnosed with colorectal neoplasm, and 64 patients (225 polyps) were enrolled and randomly allocated into the Net forceps group (NET) and the Catcher Tagged group (TAG). In TAG, 3 types of colored ring-threads were used to retrieve resected polyps. After local injection of natural saline, ring-threads were placed close to polyps. The primary outcome was the number of one-to-one correspondence locations (UMIN000020826). Results: There was significant difference in one-to-one correspondence (p = 0.004). The average retrieval procedure time was 13.56 ± 3.47 (min) in NET and 3.55 ± 1.68 in TAG (p = 0.006). In NET, 1 polyp in each of 4 cases was lost during endoscopic mucosal resection and 2 polyps were lost in 1 case. In TAG, no polyp was lost (p = 0.016). Conclusion: The Catcher Tagged method is very useful for accurate one-to-one correspondence locations and pathological evaluation, and easy-to-retrieve multiple resected specimens.

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“…This technical difficulty is likely to be associated with complications, especially perforation. Previous studies used long procedure times (more than 120 or 150 min); perforation and piecemeal resection mark the technical difficulty of colorectal ESD, and it was found that technical difficulty was associated with factors including mobility of tumor location (mobile: sigmoid or transverse colon; fixed: rectum, descending colon, ascending colon, or cecum), lesions at a fold or flexure, huge tumor (≥5 or ≥4 cm), tumors associated with scarring or local recurrence (presence of severe fibrosis) [31,32,33]. In recent years, in order to obtain adequate tissue tension and clear visibility of the tissue, reduce operating time and improve security, many ESD-assisted methods have been developed, such as the clip-with-line method, the sinker-assisted method, the internal traction method, the outer route method, the double-scope method, the external forceps method and the endoscopic surgical platform [34].…”

Section: Technical Aspects Of Endoscopic Approaches For Early Crcmentioning

confidence: 99%

Endoscopic Approach for Superficial Colorectal Neoplasms

Xu¹,

Yang

Jin

et al. 2016

Gastrointest Tumors

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Background: Colorectal cancer (CRC) is the third most commonly diagnosed cancer in males and the second in females, with an estimated 1.4 million cases and 693,900 deaths in 2012. Colonoscopy is the cornerstone for the detection and prevention of CRC. In addition, endoscopic treatment for CRC at an early stage can effectively improve patients' quality of life and cure rate. Summary: This review focuses on endoscopic approaches, including white light endoscopy, chromoendoscopy, magnifying endoscopy and therapeutic endoscopy, for the evaluation and treatment of superficial colorectal neoplasms. Key Message: Understanding the preoperative evaluation, indications and techniques of endoscopic mucosal resection/endoscopic submucosal dissection as well as postoperative surveillance for superficial colorectal neoplasms is critical for providing appropriate management to the patients. Practical Implications: Endoscopic therapy, a method preserving organ function and improving quality of life, is a widely applied microinvasive treatment for superficial colorectal neoplasms. This review describes the basics and developments of endoscopic approaches and may facilitate daily practice for superficial colorectal neoplasms.

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Technical difficulty according to location, and risk factors for perforation, in endoscopic submucosal dissection of colorectal tumors

Abstract: ESD was slower for sigmoid colon tumors than for tumors in other areas, suggesting that ESD was technically more difficult in the sigmoid colon than in other colorectal areas. Submucosal fibrosis was independently associated with perforation during colorectal ESD.

Cited by 87 publications

References 23 publications

Predictive factors for technically difficult endoscopic submucosal dissection in large colorectal tumors

Predictive factors for technically difficult endoscopic submucosal dissection in large colorectal tumors

One-to-One Correspondence Locations of Resected Polyps after Endoscopic Resection Using Catcher Tagged Method: A Randomized Prospective Study

Endoscopic Approach for Superficial Colorectal Neoplasms

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