Single-Center-Erfahrung mit der Endoskopischen Submukosa-Dissektion (ESD) bei prämalignen und malignen gastrointestinalen Neoplasien

Translated title of the contribution: Single centre experience of endoscopic submucosal dissection (ESD) in premalignant and malignant gastrointestinal neoplasia

S. Höbel, R. Baumbach, P. Dautel, K. J. Oldhafer, A. Stang, B. Feyerabend, Naohisa Yahagi, S. Faiss

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Introduction: Worldwide endoscopic submucosal dissection (ESD) of early GI cancers or premalignant neoplasia is becoming increasingly important. In Germany ESD is restricted to larger endoscopic institutions and only a few literature reports are available. The aim of the present study is to describe the results of 46 ESDs conducted in a German endoscopic centre. Material and Methods: Between June 2007 and May 2012 46 ESDs in 45 patients (33 men, 12 women, mean age 66.1 years) were performed in the oesophagus (n = 17), stomach (n = 23) and rectum (n = 6). Data were collected for the en-bloc, R0 and R0 en-bloc resection rates as well as for complications, the curative resection and the local recurrence rates. In order to demonstrate a learning curve, results were evaluated for two periods (June 2007 to November 2010 vs. December 2010 to May 2012). Results: ESD was technically possible in 93.5 %. En-bloc, R0, R0 en-bloc and curative resection rates were 90.7 %, 74.4 %, 67.4 % and 65.1 %, respectively. The complication rate was 13 %. In the second period en-bloc and R0 en-bloc resection rates increased from 81 % to 100 % and, respectively, from 52.4 % to 81.8 %. After a medium follow-up of 11.4 months, local tumour recurrence occurred in 10 %. In cases of curative R0 en bloc resection of malignant tumours no tumour recurrence occurred. Discussion: Despite the small number of patients, the present data underline the value of ESD, especially in cases of R0 en-bloc resections in the therapy for premalignant and early malignant GI tumours. Due to the required learning curve, ESD should be restricted to larger endoscopic centres in Germany.

Original languageGerman
Pages (from-to)193-199
Number of pages7
JournalZeitschrift fur Gastroenterologie
Volume52
Issue number2
DOIs
Publication statusPublished - 2014 Feb

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Neoplasms
Learning Curve
Recurrence
Germany
Rectum
Esophagus
Endoscopic Mucosal Resection
Stomach
Therapeutics

Keywords

  • early cancer
  • endoscopic submucosal dissection (ESD)
  • endoscopic tumour resection

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Single-Center-Erfahrung mit der Endoskopischen Submukosa-Dissektion (ESD) bei prämalignen und malignen gastrointestinalen Neoplasien. / Höbel, S.; Baumbach, R.; Dautel, P.; Oldhafer, K. J.; Stang, A.; Feyerabend, B.; Yahagi, Naohisa; Faiss, S.

In: Zeitschrift fur Gastroenterologie, Vol. 52, No. 2, 02.2014, p. 193-199.

Research output: Contribution to journalArticle

Höbel, S. ; Baumbach, R. ; Dautel, P. ; Oldhafer, K. J. ; Stang, A. ; Feyerabend, B. ; Yahagi, Naohisa ; Faiss, S. / Single-Center-Erfahrung mit der Endoskopischen Submukosa-Dissektion (ESD) bei prämalignen und malignen gastrointestinalen Neoplasien. In: Zeitschrift fur Gastroenterologie. 2014 ; Vol. 52, No. 2. pp. 193-199.
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abstract = "Introduction: Worldwide endoscopic submucosal dissection (ESD) of early GI cancers or premalignant neoplasia is becoming increasingly important. In Germany ESD is restricted to larger endoscopic institutions and only a few literature reports are available. The aim of the present study is to describe the results of 46 ESDs conducted in a German endoscopic centre. Material and Methods: Between June 2007 and May 2012 46 ESDs in 45 patients (33 men, 12 women, mean age 66.1 years) were performed in the oesophagus (n = 17), stomach (n = 23) and rectum (n = 6). Data were collected for the en-bloc, R0 and R0 en-bloc resection rates as well as for complications, the curative resection and the local recurrence rates. In order to demonstrate a learning curve, results were evaluated for two periods (June 2007 to November 2010 vs. December 2010 to May 2012). Results: ESD was technically possible in 93.5 {\%}. En-bloc, R0, R0 en-bloc and curative resection rates were 90.7 {\%}, 74.4 {\%}, 67.4 {\%} and 65.1 {\%}, respectively. The complication rate was 13 {\%}. In the second period en-bloc and R0 en-bloc resection rates increased from 81 {\%} to 100 {\%} and, respectively, from 52.4 {\%} to 81.8 {\%}. After a medium follow-up of 11.4 months, local tumour recurrence occurred in 10 {\%}. In cases of curative R0 en bloc resection of malignant tumours no tumour recurrence occurred. Discussion: Despite the small number of patients, the present data underline the value of ESD, especially in cases of R0 en-bloc resections in the therapy for premalignant and early malignant GI tumours. Due to the required learning curve, ESD should be restricted to larger endoscopic centres in Germany.",
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AU - Höbel, S.

AU - Baumbach, R.

AU - Dautel, P.

AU - Oldhafer, K. J.

AU - Stang, A.

AU - Feyerabend, B.

AU - Yahagi, Naohisa

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AB - Introduction: Worldwide endoscopic submucosal dissection (ESD) of early GI cancers or premalignant neoplasia is becoming increasingly important. In Germany ESD is restricted to larger endoscopic institutions and only a few literature reports are available. The aim of the present study is to describe the results of 46 ESDs conducted in a German endoscopic centre. Material and Methods: Between June 2007 and May 2012 46 ESDs in 45 patients (33 men, 12 women, mean age 66.1 years) were performed in the oesophagus (n = 17), stomach (n = 23) and rectum (n = 6). Data were collected for the en-bloc, R0 and R0 en-bloc resection rates as well as for complications, the curative resection and the local recurrence rates. In order to demonstrate a learning curve, results were evaluated for two periods (June 2007 to November 2010 vs. December 2010 to May 2012). Results: ESD was technically possible in 93.5 %. En-bloc, R0, R0 en-bloc and curative resection rates were 90.7 %, 74.4 %, 67.4 % and 65.1 %, respectively. The complication rate was 13 %. In the second period en-bloc and R0 en-bloc resection rates increased from 81 % to 100 % and, respectively, from 52.4 % to 81.8 %. After a medium follow-up of 11.4 months, local tumour recurrence occurred in 10 %. In cases of curative R0 en bloc resection of malignant tumours no tumour recurrence occurred. Discussion: Despite the small number of patients, the present data underline the value of ESD, especially in cases of R0 en-bloc resections in the therapy for premalignant and early malignant GI tumours. Due to the required learning curve, ESD should be restricted to larger endoscopic centres in Germany.

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