Significance of rescue hybrid endoscopic submucosal dissection in difficult colorectal cases
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Background/Aims: Hybrid endoscopic submucosal dissection (ESD), in which an incision is made around a lesion and snaring is per-formed after submucosal dissection, has some advantages in colorectal surgery, including shorter procedure time and preventing per-foration. However, its value for rescue resection in difficult colorectal ESD cases remains unclear. This study evaluated the utility of res-cue hybrid ESD (RH-ESD). Methods: We divided 364 colorectal ESD procedures into the conventional ESD group (C-ESD, n=260), scheduled hybrid ESD group(SH-ESD, n=69), and RH-ESD group (n=35) and compared their clinical outcomes. Results: Resection time was significantly shorter in the following order: RH-ESD (149 [90–197] minutes) >C-ESD (90 [60–140] min-utes) >SH-ESD (52 [29–80] minutes). The en bloc resection rate increased significantly in the following order: RH-ESD (48.6%), SH-ESD (78.3%), and C-ESD (97.7%). An analysis of factors related to piecemeal resection of RH-ESD revealed that the submucosal dis-section rate was significantly lower in the piecemeal resection group (25% [20%–30%]) than in the en bloc resection group (40% [20%–60%]). Conclusions: RH-ESD was ineffective in terms of curative resection because of the low en bloc resection rate, but was useful for avoid-ing surgery.
Abstract
Background/Aims: Hybrid endoscopic submucosal dissection (ESD), in which an incision is made around a lesion and snaring is per-formed after submucosal dissection, has some advantages in colorectal surgery, including shorter procedure time and preventing per-foration. However, its value for rescue resection in difficult colorectal ESD cases remains unclear. This study evaluated the utility of res-cue hybrid ESD (RH-ESD). Methods: We divided 364 colorectal ESD procedures into the conventional ESD group (C-ESD, n=260), scheduled hybrid ESD group(SH-ESD, n=69), and RH-ESD group (n=35) and compared their clinical outcomes. Results: Resection time was significantly shorter in the following order: RH-ESD (149 [90–197] minutes) >C-ESD (90 [60–140] min-utes) >SH-ESD (52 [29–80] minutes). The en bloc resection rate increased significantly in the following order: RH-ESD (48.6%), SH-ESD (78.3%), and C-ESD (97.7%). An analysis of factors related to piecemeal resection of RH-ESD revealed that the submucosal dis-section rate was significantly lower in the piecemeal resection group (25% [20%–30%]) than in the en bloc resection group (40% [20%–60%]). Conclusions: RH-ESD was ineffective in terms of curative resection because of the low en bloc resection rate, but was useful for avoid-ing surgery.
참고문헌 (27)
- Cao Y, "Meta-analysis of endoscopic submucosal dissection versus endoscopic mucosal resection for tumors of the gastrointestinal tract", Endoscopy, 41, pp.751~757 (2009)
- Lian J, "A meta-analysis of endoscopic submucosal dissection and EMR for early gastric cancer", Gastrointest Endosc, 76, pp.763~770 (2012)
- Fujiya M, "Efficacy and adverse events of EMR and endoscopic submucosal dissection for the treatment of colon neoplasms : a meta-analysis of studies comparing EMR and endoscopic submucosal dissection", Gastrointest Endosc, 81, pp.583~595 (2015)
- ASGE Technology Committee, "Endoscopic submucosal dissection", Gastrointest Endosc, 81, pp.1311~1325 (2015)
- Abe N, "Multicenter study of the long-term outcomes of endoscopic submucosal dissection for early gastric cancer in patients 80 years of age or older", Gastric Cancer, 15, pp.70~75 (2012)
- Yamaguchi H, "Co-treatment with endoscopic laryngopharyngeal surgery and endoscopic submucosal dissection", Auris Nasus Larynx, 48, pp.457~463 (2021)
- Kim ES, "Factors predictive of perforation during endoscopic submucosal dissection for the treatment of colorectal tumors", Endoscopy, 43, pp.573~578 (2011)
- Yamaguchi H, "Predictive factors of postendoscopic submucosal dissection electrocoagulation syndrome and the utility of computed tomography scan after esophageal endoscopic submucosal dissection", Digestion, 101, pp.579~589 (2020)
- Mizushima T, "Technical difficulty according to location, and risk factors for perforation, in endoscopic submucosal dissection of colorectal tumors", Surg Endosc, 29, pp.133~139 (2015)
- Tanaka S, "JGES guidelines for colorectal endoscopic submucosal dissection", endoscopic mucosal resection, 2015, pp.27, 417~434
- Toyonaga T, "Endoscopic submucosal dissection(ESD)versus simplified", hybrid ESD, 2014, pp.24, 191~199
- Jung Y, "Factors predictive of complete excision of large colorectal neoplasia using hybrid endoscopic submucosal dissection : a KASID multicenter study", Dig Dis Sci, 63, pp.2773~2779 (2018)
- Oka S, "Local recurrence after endoscopic resection for large colorectal neoplasia : a multicenter prospective study in Japan", Am J Gastroenterol, 110, pp.697~707 (2015)
- Santos JB, "Risk factors for adverse events of colorectal endoscopic submucosal dissection : a systematic review and meta-analysis", Eur J Gastroenterol Hepatol, 33(1S Suppl 1), pp.e33~ (2021)
- Fuccio L, "Clinical outcomes after endoscopic submucosal dissection for colorectal neoplasia : a systematic review and meta-analysis", Gastrointest Endosc, 86, pp.74~86 (2017)
- Tanaka S, "Endoscopic submucosal dissection for colorectal neoplasia : possibility of standardization", Gastrointest Endosc, 66, pp.100~107 (2007)
- Bae JH, "Optimized hybrid endoscopic submucosal dissection for colorectal tumors : a randomized controlled trial", Gastrointest Endosc, 83, pp.584~592 (2016)
- Okamoto Y, "Indications and outcomes of colorectal hybrid endoscopic submucosal dissection : a large multicenter 10-year study", Surg Endosc, 36, pp.1894~1902 (2022)
- Terasaki M, "Clinical outcomes of endoscopic submucosal dissection and endoscopic mucosal resection for laterally spreading tumors larger than 20 mm", J Gastroenterol Hepatol, 27, pp.734~740 (2012)
- Byeon JS, "Endoscopic submucosal dissection with or without snaring for colorectal neoplasms", Gastrointest Endosc, 74, pp.1075~1083 (2011)
- Yoshida N, "Hybrid ESD techniques for colorectal tumor ESD", Intestine, 17, pp.51~58 (2013)
- Okamoto K, "Efficacy of hybrid endoscopic submucosal dissection(ESD)as a rescue treatment in difficult colorectal ESD cases", Dig Endosc, 29(Suppl 2), pp.45~52 (2017)
- Milano RV, "Resection outcomes and recurrence rates of endoscopic submucosal dissection(ESD)and hybrid ESD for colorectal tumors in a single Italian center", Surg Endosc, 32, pp.2328~2339 (2018)
- Kang DU, "Long-term clinical outcomes of endoscopic submucosal dissection for colorectal neoplasia with or without the hybrid technique", Colorectal Dis, 22, pp.2008~2017 (2020)
- Wang XY, "Hybrid endoscopic submucosal dissection : an alternative resection modality for large laterally spreading tumors in the cecum?", BMC Gastroenterol, 21, pp.203~ (2021)
- Papparella LG, "Efficacy and safety of endoscopic resection techniques of large colorectal lesions : experience of a referral center in Italy", Eur J Gastroenterol Hepatol, 34, pp.375~381 (2022)
- Saito Y, "Clinical outcome of endoscopic submucosal dissection versus endoscopic mucosal resection of large colorectal tumors as determined by curative resection", Surg Endosc, 24, pp.343~352 (2010)