Pocket-creation method facilitates endoscopic submucosal dissection of colorectal laterally spreading tumors, non-granular type

Hirotsugu Sakamoto; Yoshikazu Hayashi; Yoshimasa Miura; Satoshi Shinozaki; Haruo Takahashi; Hisashi Fukuda; Masahiro Okada; Yuji Ino; Takahito Takezawa; Keijiro Sunada; Alan Kawarai Lefor; Hironori Yamamoto

doi:10.1055/s-0042-122778

Endoscopy International Open, Table of Contents

CC BY-NC-ND 4.0 · Endosc Int Open 2017; 05(02): E123-E129
DOI: 10.1055/s-0042-122778

Original article

Pocket-creation method facilitates endoscopic submucosal dissection of colorectal laterally spreading tumors, non-granular type

Hirotsugu Sakamoto

¹Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan

,

Yoshikazu Hayashi

¹Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan

,

Yoshimasa Miura

¹Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan

,

Satoshi Shinozaki

¹Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan

²Shinozaki Medical Clinic, Utsunomiya, Japan

,

Haruo Takahashi

¹Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan

,

Hisashi Fukuda

¹Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan

,

Masahiro Okada

¹Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan

,

Yuji Ino

¹Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan

,

Takahito Takezawa

¹Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan

,

Keijiro Sunada

¹Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan

,

Alan Kawarai Lefor

³Department of Surgery, Jichi Medical University, Shimotsuke, Japan

,

Hironori Yamamoto

¹Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan

› Author Affiliations

Abstract

Background and study aims The pocket-creation method (PCM) is a novel strategy for endoscopic submucosal dissection (ESD). The aim of this study is to determine the efficacy of the PCM for colorectal laterally spreading tumors, non-granular type (LST-NG).

Patients and methods The records of 126 consecutive patients with colorectal LST-NG who underwent ESD between April 2012 and July 2015 were retrospectively reviewed. Patients were divided into PCM (n = 73) and conventional method (CM) (n = 53) groups.

Results The en bloc resection rate in the PCM group was significantly higher than in the CM group (100 % [73/73] vs. 92 % [49/53], P = 0.03). The en bloc resection rate with severe fibrosis was higher in the PCM group than in the CM group (100 % [3/3] vs. 60 % [3/5]). The R0 resection rate for the two groups was not statistically significantly different (93 % [68/73] vs. 91 % [48/53], P = 0.74). The perforation rate in the PCM group was lower than in the CM group although not statistically significantly less (0 % 0/73 vs. 4 % 2/53, P = 0.18). For lesions resected en bloc, dissection speed for the PCM group was significantly faster than for the CM group (median [IQR], 19 [13 –24] vs. 14 [10 – 22] mm²/min, P = 0.03).

Conclusion ESD using PCM achieves a reliable and safe resection of colorectal LST-NG.

Full Text

References

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