Feasibility, Safety and Effectiveness of Endoscopic Submucosal Dissection of Gastrointestinal Lesions In Out- Vs Inpatient Setting

Aims Endoscopic submucosal dissection (ESD) allows ‘en-bloc’ resection of superficial gastrointestinal neoplasms, which has implications for complete excision and pathological analysis. Patients undergoing ESD are usually managed as inpatients. This study aimed to compare feasibility, safety and efficacy of ESD for in- and outpatient setting.

Methods We retrospectively reviewed a prospective cohort of 111 consecutive patients undergoing ESD at one Italian tertiary referral center, from March 2018 to March 2020.

Results One hundred and eleven in- and outpatients with 111 lesions undergoing ESD were reviewed. Of these, 77.5 % were inpatients and 22.5 % outpatients. Mean age was 70.45±12.6 and 66.6±11.8 years, respectively (p = 0.19). In both groups, most lesions were lateral spreading tumors (LSTs): 51.8 % and 52 %, respectively. Inpatients showed a slightly larger mean lesion size (37.3±15.1 vs 34.8±16.5 mm, p = 0.48) and a higher prevalence of Kudo type IV lesions (70.4 % vs 54.2 %, p = 0.04). All procedures but one were technically successful. The median procedure time was 110.3 vs 80.2 minutes (p = 0.006). Complications were registered in 6/86 (7 %) of inpatients vs 1/25 (4 %) of outpatients (p = 0.25) and included 2 intraprocedural perforations and 4 cases of bleeding in the inpatient group, 1 bleeding in the outpatient group. All outpatients were observed for 4-6 hours and discharged the same day of procedure. R0 resection was achieved in 73/87 (84.9 %) and 19/25 (76 %) of patients, respectively (p = 0.3). After a median follow-up of 10.5 months, recurrence was observed in 1/86 inpatients and in 0/25 outpatients. The only case of recurrence was radically treated with cold EMR.

Conclusions Our experience confirmed that ESD is feasible, effective and safe also in outpatient settings for selected gastrointestinal lesions.

Citation: Sferrazza S, Maida M, Vieceli F et al. eP11 FEASIBILITY, SAFETY AND EFFECTIVENESS OF ENDOSCOPIC SUBMUCOSAL DISSECTION OF GASTROINTESTINAL LESIONS IN OUT- VS INPATIENT SETTING. Endoscopy 2021; 53: S100.

Publication History

Article published online:
19 March 2021