Long-term outcomes of endoscopic submucosal dissection for colorectal epithelial neoplasms

K. Niimi, M. Fujishiro, S. Kodashima, O. Goto, S. Ono, K. Hirano, C. Minatsuki, N. Yamamichi, K. Koike

Research output: Contribution to journalArticle

111 Citations (Scopus)

Abstract

Background and aims: Endoscopic submucosal dissection (ESD) provides a high en bloc resection rate with less invasiveness than surgical resection for large or scarring gastrointestinal neoplasms. However, detailed outcomes in colorectal ESD are still lacking. The aim of our study was to elucidate short- and long-term outcomes of colorectal ESD. Patients and methods: 310 consecutive colorectal epithelial neoplasms (146 adenomas, 164 carcinomas), in 290 patients, which fulfilled our indication criteria and were treated with ESD between July 2000 and December 2008 were studied. ESD was done by three skilled endoscopists. As short-term outcomes, rates of en bloc resection, en bloc plus R0 resection, and major complications were analyzed. As long-term outcomes, disease-free and overall survival were assessed in 224 patients. Results: Rates of en bloc resection and en bloc plus R0 resection were 90.3% and 74.5%, respectively. Eight patients underwent additional colectomy due to histopathologically proven possible node-positive cancer. Intraoperative perforations occurred with 14 lesions (4.5%), which were treated successfully only by endoscopic clipping. Emergent surgery was needed for one case of postoperative perforation. Blood transfusion due to intraoperative massive bleeding was required in 1 case (0.3%). Postoperative bleeding occurred with four lesions (1.3%), and was endoscopically managed without blood transfusion. Local recurrence was detected in 4 lesions (4/202 patients, 2.0%); resection had been piecemeal in all 4. During a median follow-up of 38.7 months (range 12.8104.2), the 3- and 5-year overall/disease-specific survivals were 97.1/100% and 95.3/100%, respectively. Conclusions: Colorectal ESD showed favorable long-term outcomes. It may largely replace colectomy for node-negative colorectal epithelial neoplasia.

Original languageEnglish
Pages (from-to)723-729
Number of pages7
JournalEndoscopy
Volume42
Issue number9
DOIs
Publication statusPublished - 2010
Externally publishedYes

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Glandular and Epithelial Neoplasms
Colorectal Neoplasms
Colectomy
Blood Transfusion
Hemorrhage
Gastrointestinal Neoplasms
Adenoma
Disease-Free Survival
Cicatrix
Endoscopic Mucosal Resection
Neoplasms
Carcinoma
Recurrence
Survival

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Niimi, K., Fujishiro, M., Kodashima, S., Goto, O., Ono, S., Hirano, K., ... Koike, K. (2010). Long-term outcomes of endoscopic submucosal dissection for colorectal epithelial neoplasms. Endoscopy, 42(9), 723-729. https://doi.org/10.1055/s-0030-1255675

Long-term outcomes of endoscopic submucosal dissection for colorectal epithelial neoplasms. / Niimi, K.; Fujishiro, M.; Kodashima, S.; Goto, O.; Ono, S.; Hirano, K.; Minatsuki, C.; Yamamichi, N.; Koike, K.

In: Endoscopy, Vol. 42, No. 9, 2010, p. 723-729.

Research output: Contribution to journalArticle

Niimi, K, Fujishiro, M, Kodashima, S, Goto, O, Ono, S, Hirano, K, Minatsuki, C, Yamamichi, N & Koike, K 2010, 'Long-term outcomes of endoscopic submucosal dissection for colorectal epithelial neoplasms', Endoscopy, vol. 42, no. 9, pp. 723-729. https://doi.org/10.1055/s-0030-1255675
Niimi, K. ; Fujishiro, M. ; Kodashima, S. ; Goto, O. ; Ono, S. ; Hirano, K. ; Minatsuki, C. ; Yamamichi, N. ; Koike, K. / Long-term outcomes of endoscopic submucosal dissection for colorectal epithelial neoplasms. In: Endoscopy. 2010 ; Vol. 42, No. 9. pp. 723-729.
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AU - Niimi, K.

AU - Fujishiro, M.

AU - Kodashima, S.

AU - Goto, O.

AU - Ono, S.

AU - Hirano, K.

AU - Minatsuki, C.

AU - Yamamichi, N.

AU - Koike, K.

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