Endoscopic submucosal dissection for colorectal lateral spreading tumors larger than 10 cm

Is it feasible?

Da Hyun Jung, Young Hoon Youn, Jie-Hyun Kim, HyoJin Park

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background: Colorectal endoscopic submucosal dissection (ESD) was applied to lesions, such as giant colorectal lateral spreading tumors (LSTs) > 10 cm, by an expert ESD endoscopist despite several limitations, such as a relatively high perforation rate and high technical difficulty. Objective: To investigate the feasibility and safety of ESD for giant colorectal LSTs ≤ 10 cm. Design: Retrospective study. Setting: Tertiary-care center. Patients: A total of 163 patients underwent colorectal ESD between 2009 and 2014 by a single expert ESD endoscopist at Gangnam Severance Hospital, Seoul, Korea. Among them, 9 patients had giant colorectal LSTs ≤ 10 cm. Interventions: Review of records. Main Outcome Measurements: Clinicopathologic factors and oncologic outcome associated with ESD between giant colorectal LSTs and others. Results: Colorectal LSTs ≤ 10 cm were classified as giant colorectal LSTs. Nine giant colorectal LST lesions were localized to the following regions: descending colon (n = 1), sigmoid colon (n = 1), and rectum (n = 7). The average maximal diameter of giant colorectal LSTs was 120.8 mm, and the procedure time was 270.0 minutes. Two lesions were of the whole nodular type, and 7 were focal nodular lesions. The en bloc and curative resection rates for ESD for giant colorectal LSTs were 88.9% and 100%, respectively. The adverse event rate was 44.4%. No strictures, local recurrences, or distant metastases occurred over a mean follow-up period of 27.1 months. Limitations: Retrospective, single-center study. Conclusions: ESD of giant colorectal LSTs appears to be a feasible and curative treatment, even though it is associated with a higher adverse event rate, higher degree of technical difficulty, and longer procedure time.

Original languageEnglish
Pages (from-to)614-620
Number of pages7
JournalGastrointestinal Endoscopy
Volume81
Issue number3
DOIs
Publication statusPublished - 2015 Mar 1

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Neoplasms
Endoscopic Mucosal Resection
Descending Colon
Sigmoid Colon
Korea
Rectum
Tertiary Care Centers
Pathologic Constriction
Retrospective Studies
Neoplasm Metastasis
Safety
Recurrence
Therapeutics

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

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title = "Endoscopic submucosal dissection for colorectal lateral spreading tumors larger than 10 cm: Is it feasible?",
abstract = "Background: Colorectal endoscopic submucosal dissection (ESD) was applied to lesions, such as giant colorectal lateral spreading tumors (LSTs) > 10 cm, by an expert ESD endoscopist despite several limitations, such as a relatively high perforation rate and high technical difficulty. Objective: To investigate the feasibility and safety of ESD for giant colorectal LSTs ≤ 10 cm. Design: Retrospective study. Setting: Tertiary-care center. Patients: A total of 163 patients underwent colorectal ESD between 2009 and 2014 by a single expert ESD endoscopist at Gangnam Severance Hospital, Seoul, Korea. Among them, 9 patients had giant colorectal LSTs ≤ 10 cm. Interventions: Review of records. Main Outcome Measurements: Clinicopathologic factors and oncologic outcome associated with ESD between giant colorectal LSTs and others. Results: Colorectal LSTs ≤ 10 cm were classified as giant colorectal LSTs. Nine giant colorectal LST lesions were localized to the following regions: descending colon (n = 1), sigmoid colon (n = 1), and rectum (n = 7). The average maximal diameter of giant colorectal LSTs was 120.8 mm, and the procedure time was 270.0 minutes. Two lesions were of the whole nodular type, and 7 were focal nodular lesions. The en bloc and curative resection rates for ESD for giant colorectal LSTs were 88.9{\%} and 100{\%}, respectively. The adverse event rate was 44.4{\%}. No strictures, local recurrences, or distant metastases occurred over a mean follow-up period of 27.1 months. Limitations: Retrospective, single-center study. Conclusions: ESD of giant colorectal LSTs appears to be a feasible and curative treatment, even though it is associated with a higher adverse event rate, higher degree of technical difficulty, and longer procedure time.",
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Endoscopic submucosal dissection for colorectal lateral spreading tumors larger than 10 cm : Is it feasible? / Jung, Da Hyun; Youn, Young Hoon; Kim, Jie-Hyun; Park, HyoJin.

In: Gastrointestinal Endoscopy, Vol. 81, No. 3, 01.03.2015, p. 614-620.

Research output: Contribution to journalArticle

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T1 - Endoscopic submucosal dissection for colorectal lateral spreading tumors larger than 10 cm

T2 - Is it feasible?

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AU - Youn, Young Hoon

AU - Kim, Jie-Hyun

AU - Park, HyoJin

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N2 - Background: Colorectal endoscopic submucosal dissection (ESD) was applied to lesions, such as giant colorectal lateral spreading tumors (LSTs) > 10 cm, by an expert ESD endoscopist despite several limitations, such as a relatively high perforation rate and high technical difficulty. Objective: To investigate the feasibility and safety of ESD for giant colorectal LSTs ≤ 10 cm. Design: Retrospective study. Setting: Tertiary-care center. Patients: A total of 163 patients underwent colorectal ESD between 2009 and 2014 by a single expert ESD endoscopist at Gangnam Severance Hospital, Seoul, Korea. Among them, 9 patients had giant colorectal LSTs ≤ 10 cm. Interventions: Review of records. Main Outcome Measurements: Clinicopathologic factors and oncologic outcome associated with ESD between giant colorectal LSTs and others. Results: Colorectal LSTs ≤ 10 cm were classified as giant colorectal LSTs. Nine giant colorectal LST lesions were localized to the following regions: descending colon (n = 1), sigmoid colon (n = 1), and rectum (n = 7). The average maximal diameter of giant colorectal LSTs was 120.8 mm, and the procedure time was 270.0 minutes. Two lesions were of the whole nodular type, and 7 were focal nodular lesions. The en bloc and curative resection rates for ESD for giant colorectal LSTs were 88.9% and 100%, respectively. The adverse event rate was 44.4%. No strictures, local recurrences, or distant metastases occurred over a mean follow-up period of 27.1 months. Limitations: Retrospective, single-center study. Conclusions: ESD of giant colorectal LSTs appears to be a feasible and curative treatment, even though it is associated with a higher adverse event rate, higher degree of technical difficulty, and longer procedure time.

AB - Background: Colorectal endoscopic submucosal dissection (ESD) was applied to lesions, such as giant colorectal lateral spreading tumors (LSTs) > 10 cm, by an expert ESD endoscopist despite several limitations, such as a relatively high perforation rate and high technical difficulty. Objective: To investigate the feasibility and safety of ESD for giant colorectal LSTs ≤ 10 cm. Design: Retrospective study. Setting: Tertiary-care center. Patients: A total of 163 patients underwent colorectal ESD between 2009 and 2014 by a single expert ESD endoscopist at Gangnam Severance Hospital, Seoul, Korea. Among them, 9 patients had giant colorectal LSTs ≤ 10 cm. Interventions: Review of records. Main Outcome Measurements: Clinicopathologic factors and oncologic outcome associated with ESD between giant colorectal LSTs and others. Results: Colorectal LSTs ≤ 10 cm were classified as giant colorectal LSTs. Nine giant colorectal LST lesions were localized to the following regions: descending colon (n = 1), sigmoid colon (n = 1), and rectum (n = 7). The average maximal diameter of giant colorectal LSTs was 120.8 mm, and the procedure time was 270.0 minutes. Two lesions were of the whole nodular type, and 7 were focal nodular lesions. The en bloc and curative resection rates for ESD for giant colorectal LSTs were 88.9% and 100%, respectively. The adverse event rate was 44.4%. No strictures, local recurrences, or distant metastases occurred over a mean follow-up period of 27.1 months. Limitations: Retrospective, single-center study. Conclusions: ESD of giant colorectal LSTs appears to be a feasible and curative treatment, even though it is associated with a higher adverse event rate, higher degree of technical difficulty, and longer procedure time.

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