Superficial neoplasia involving the Ileocecal valve: Clinical outcomes of endoscopic submucosal dissection.
Dig Liver Dis
; 53(7): 889-894, 2021 07.
Article
em En
| MEDLINE
| ID: mdl-33762176
ABSTRACT
BACKGROUND:
Endoscopic submucosal dissection (ESD) is the treatment of choice for colorectal superficial neoplasia, but certain anatomical locations are challenging even for skilled endoscopists. Ileocecal valve (ICV) is considered a technically challenging site for ESD.OBJECTIVE:
Aim of this study was to analyze efficacy and safety of Endoscopic Submucosal Dissection in the treatment of colorectal neoplasia involving the ileocecal valve (ICV)DESIGN:
Retrospective study. PATIENTS We retrospectively evaluated 1507 consecutive patients undergoing ESD at two tertiary referral centres for ESD (Italy and Japan) from January 2008 to March 2020. MAIN OUTCOMEMEASURES:
Demographic, clinical, procedural, and follow-up data was collected, analysed, and compared between patients with ileocecal valve lesions (ICVL) and patients with non-ICVL.RESULTS:
Overall, 1507 patients were enrolled (872â¯M, 57.8%), of these 53 patients had lesions involving the ICV. Mean age was 70.2 years (range, 53-83 years). En-bloc resection was achieved in 52 (98%) patients. The median specimen size of ICVL was 36.4â¯mm (range, 8-80â¯mm), significantly smaller than non-ICVL (pâ¯=â¯0.005). Procedure time was significantly longer in the ICVL group, (71.3â¯vs. 58.9â¯min; pâ¯=â¯0.03). Non Granular Type Laterally Spreading Tumors (LST-NG) were significantly more frequent in the ICVL group compared to rectum (52.8% vs. 25.7; pâ¯=â¯0.0001). En-bloc resection rate in the ileocecal region did not differ significantly between groups (pâ¯=â¯0.20). Complications such as perforation and postoperative occurred respectively in 3/53 (5.7%) and 1/53 (2%) patient, and were treated conservatively. At first surveillance colonoscopy performed at 6 months, recurrent adenoma was detected in 2/53 patients (3.9%).CONCLUSIONS:
ESD is safe and effective for the treatment of colorectal neoplasia involving the ileocecal valve if performed by expert endoscopist in referral centres.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Adenoma
/
Colonoscopia
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Ressecção Endoscópica de Mucosa
/
Neoplasias do Íleo
/
Valva Ileocecal
Tipo de estudo:
Observational_studies
Limite:
Aged
/
Aged80
/
Female
/
Humans
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Male
/
Middle aged
País/Região como assunto:
Asia
/
Europa
Idioma:
En
Revista:
Dig Liver Dis
Assunto da revista:
GASTROENTEROLOGIA
Ano de publicação:
2021
Tipo de documento:
Article