Feasibility of endoscopic submucosal dissection for patients with chronic renal failure on hemodialysis

Osamu Goto, Mitsuhiro Fujishiro, Shinya Kodashima, Satoshi Ono, Keiko Niimi, Nobutake Yamamichi, Masao Omata

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: Endoscopic submucosal dissection (ESD) is expected as a curative method for node-negative gastrointestinal cancers. Little is known about ESD for patients with end-stage chronic renal failure (CRF) on hemodialysis. We aimed to evaluate the efficacy and safety of ESD for patients with CRF on hemodialysis. Methods: Ten consecutive patients with 12 lesions who underwent ESD (stomach, seven; colorectum, three) between March 2002 and August 2007 were retrospectively investigated in terms of the technical feasibility and complications. Results: All the lesions were resected in a single piece and en-bloc and R0 resection rate was 100%. Histology revealed that all the lesions fulfilled the criteria of node-negative cancers. Delayed bleeding requiring blood transfusion on the day after ESD, and shunt occlusion, which necessitated a radiological intervention 7 days after ESD, occurred in one stomach case. Delayed perforation followed by emergency surgery 2 days after ESD occurred in one colorectal case. Conclusions: ESD for CRF patients may be technically feasible, but substantial risks should be considered. Early detection of late-onset complications is essential with intensive medical check-up for at least 1 week in order to prevent complications from becoming severe.

Original languageEnglish
Pages (from-to)45-48
Number of pages4
JournalDigestive Endoscopy
Volume22
Issue number1
DOIs
Publication statusPublished - 2010 Jan 1

Keywords

  • Chronic renal failure
  • Endoscopic submucosal dissection
  • Gastrointestinal cancers
  • Hemodialysis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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