Abstract
Although endoscopic submucosal dissection (ESD) can remove gastrointestinal neoplasia even with severe fibrosis into the submucosa, the safety and efficacy of ESD for colorectal neoplasia (CRN) located on the suture line of anastomosis (SLA) has not been assessed. The aim of this study was to evaluate the feasibility of ESD for CRN located on the SLA, performed by a highly skilled endoscopist. Three consecutive patients with CRN located on the SLA were treated with ESD. In all cases, ESD was safely performed without any adverse events. The median tumor size of the resected CRN was 30 mm (range 12-75 mm) and the median procedure time was 150 min (range 50-150 min). Curative resection was achieved in two cases without local recurrence during a 12-month observation period. In one case, the CRN were resected in an almost en bloc fashion, but a decision was made to spare the edge of the CRN that was directly on the SLA in order to avoid delayed perforation, and this edge was instead removed with hemostatic forceps. Although the surveillance colonoscopy revealed a small residual neoplasia, it was curatively treated by endoscopically. In all cases, ESD managed to avoid the need for repetitive surgery. This case series suggests the feasibility of ESD performed by a highly skilled endoscopist as a curative treatment for the CRN located on the SLA.
| Original language | English |
|---|---|
| Pages (from-to) | 290-294 |
| Number of pages | 5 |
| Journal | Clinical Journal of Gastroenterology |
| Volume | 7 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - 2014 |
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Keywords
- Colorectal neoplasia
- Endoscopic submucosal dissection
- Suture line of anastomosis
ASJC Scopus subject areas
- Gastroenterology
Cite this
Endoscopic submucosal dissection of colorectal neoplasia located on the suture line of anastomosis. / Horii, Joichiro; Uraoka, Toshio; Goto, Osamu; Ishii, Hiroyuki; Shimoda, Masayuki; Yahagi, Naohisa.
In: Clinical Journal of Gastroenterology, Vol. 7, No. 4, 2014, p. 290-294.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Endoscopic submucosal dissection of colorectal neoplasia located on the suture line of anastomosis
AU - Horii, Joichiro
AU - Uraoka, Toshio
AU - Goto, Osamu
AU - Ishii, Hiroyuki
AU - Shimoda, Masayuki
AU - Yahagi, Naohisa
PY - 2014
Y1 - 2014
N2 - Although endoscopic submucosal dissection (ESD) can remove gastrointestinal neoplasia even with severe fibrosis into the submucosa, the safety and efficacy of ESD for colorectal neoplasia (CRN) located on the suture line of anastomosis (SLA) has not been assessed. The aim of this study was to evaluate the feasibility of ESD for CRN located on the SLA, performed by a highly skilled endoscopist. Three consecutive patients with CRN located on the SLA were treated with ESD. In all cases, ESD was safely performed without any adverse events. The median tumor size of the resected CRN was 30 mm (range 12-75 mm) and the median procedure time was 150 min (range 50-150 min). Curative resection was achieved in two cases without local recurrence during a 12-month observation period. In one case, the CRN were resected in an almost en bloc fashion, but a decision was made to spare the edge of the CRN that was directly on the SLA in order to avoid delayed perforation, and this edge was instead removed with hemostatic forceps. Although the surveillance colonoscopy revealed a small residual neoplasia, it was curatively treated by endoscopically. In all cases, ESD managed to avoid the need for repetitive surgery. This case series suggests the feasibility of ESD performed by a highly skilled endoscopist as a curative treatment for the CRN located on the SLA.
AB - Although endoscopic submucosal dissection (ESD) can remove gastrointestinal neoplasia even with severe fibrosis into the submucosa, the safety and efficacy of ESD for colorectal neoplasia (CRN) located on the suture line of anastomosis (SLA) has not been assessed. The aim of this study was to evaluate the feasibility of ESD for CRN located on the SLA, performed by a highly skilled endoscopist. Three consecutive patients with CRN located on the SLA were treated with ESD. In all cases, ESD was safely performed without any adverse events. The median tumor size of the resected CRN was 30 mm (range 12-75 mm) and the median procedure time was 150 min (range 50-150 min). Curative resection was achieved in two cases without local recurrence during a 12-month observation period. In one case, the CRN were resected in an almost en bloc fashion, but a decision was made to spare the edge of the CRN that was directly on the SLA in order to avoid delayed perforation, and this edge was instead removed with hemostatic forceps. Although the surveillance colonoscopy revealed a small residual neoplasia, it was curatively treated by endoscopically. In all cases, ESD managed to avoid the need for repetitive surgery. This case series suggests the feasibility of ESD performed by a highly skilled endoscopist as a curative treatment for the CRN located on the SLA.
KW - Colorectal neoplasia
KW - Endoscopic submucosal dissection
KW - Suture line of anastomosis
UR - http://www.scopus.com/inward/record.url?scp=84906345508&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84906345508&partnerID=8YFLogxK
U2 - 10.1007/s12328-014-0492-4
DO - 10.1007/s12328-014-0492-4
M3 - Article
C2 - 26185875
AN - SCOPUS:84906345508
VL - 7
SP - 290
EP - 294
JO - Clinical Journal of Gastroenterology
JF - Clinical Journal of Gastroenterology
SN - 1865-7257
IS - 4
ER -