Zwischen EMR und ESD: Endoskopische Submukosaresektion (ESR) zur optimierten en bloc Resektion kolorektaler Läsionen bis 50 mm

Metter, K; Dumoulin, FL; Grund, K. E.; Farin, G.

doi:10.1055/s-0039-1695571

Cited by 2 publications

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“…The consequences of the quality of a specimen (piecemeal versus one-piece) for subsequent histopathology are shown in Figure 1. In this example, fragmentation and thermic artefacts prevent a reliable evaluation of submucosal infiltration depth and vertical resection margin [45].…”

Section: Endoscopic Resection Techniques and Specimen Qualitymentioning

confidence: 99%

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Endoscopic Treatment of T1 Colorectal Cancer

Metter,

Weißinger,

Várnai-Händel

et al. 2023

Cancers

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Commonly accepted criteria for curative resection of T1 colorectal cancer include R0 resection with horizontal and vertical clear margins (R0), absence of lympho-vascular or vessel infiltration (L0, V0), a low to moderate histological grading (G1/2), low tumor cell budding, and limited (<1000 µm) infiltration into the submucosa. However, submucosal infiltration depth in the absence of other high-risk features has recently been questioned as a high-risk situation for lymph-node metastasis. Consequently, endoscopic resection techniques should focus on the acquisition of qualitatively and quantitively sufficient submucosal tissue. Here, we summarize the current literature on lymph-node metastasis risk after endoscopic resection of T1 colorectal cancer. Moreover, we discuss different endoscopic resection techniques with respect to the quality of the resected specimen.

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Section: Endoscopic Resection Techniques and Specimen Qualitymentioning

confidence: 99%

“…Cancers 2023, 15, x FOR PEER REVIEW 5 of 10 artefacts prevent a reliable evaluation of submucosal infiltration depth and vertical resection margin [45]. of the resection margins is not possible, the resection status cannot be assessed, and the submucosa cannot be measured.…”

Section: Esdmentioning

confidence: 99%

Endoscopic Treatment of T1 Colorectal Cancer

Metter,

Weißinger,

Várnai-Händel

et al. 2023

Cancers

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“…A recently presented resection technique, endoscopic submucosal resection (ESR), might be such a procedure for the resection of large flat or sessile lesions (data presented in part by Metter K et al at the 2018 and 2019 meetings of the German Society for Gastroenterology [DGVS]) [8,9]. ESR is a novel method carried out with newly designed devices.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic submucosal resection: a technique using novel devices for incision and resection of neoplastic lesions

et al. 2021

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Background and study aims: Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are established techniques for the treatment of superficial gastrointestinal neoplasia. Limitations of EMR are the low en bloc resection rates for larger lesions resulting in frequent recurrences. Major disadvantages of ESD are technical difficulty and long procedure times. Here, we evaluated technical feasibility and safety of newly designed devices to perform en bloc resection of lesions sized between ca. 20-40 mm. The method will be referred to as Endoscopic Submucosal Resection (ESR). Patients and methods: This case series included 93 lesions from different localizations (11x stomach, 25x colon, 57x rectum) with a median size of 29 (10-70) mm. ESR was carried out with two novel instruments for circumferential mucosal incision and for deep submucosal resection. Results: Resection by ESR was feasible in all cases. En bloc and R0 rates were insufficient when ESR was attempted without prior circumferential mucosal incision. However, en bloc and R0 resection rates were 70% and 63%, respectively when mucosal incision was done before application of the device for submucosal resection. We observed 3 complications (2 delayed bleedings, one microperforation) but no case of emergency surgery and no 30-day mortality. Conclusions: The series demonstrates feasibility and excellent safety of ESR using two novel devices for en bloc resection of early gastrointestinal neoplasia. The technique holds the promise of relative technical ease combined with high efficacy.

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Zwischen EMR und ESD: Endoskopische Submukosaresektion (ESR) zur optimierten en bloc Resektion kolorektaler Läsionen bis 50 mm

Cited by 2 publications

References 0 publications

Endoscopic Treatment of T1 Colorectal Cancer

Endoscopic Treatment of T1 Colorectal Cancer

Endoscopic submucosal resection: a technique using novel devices for incision and resection of neoplastic lesions

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