Endoscopic submucosal dissection for superficial rectal tumors: prospective evaluation in France.
Endoscopy
; 46(8): 670-6, 2014 Aug.
Article
em En
| MEDLINE
| ID: mdl-24977400
ABSTRACT
BACKGROUND AND STUDY AIMS:
Endoscopic submucosal dissection (ESD) provides a high en bloc resection rate for superficial colorectal tumors. The aims of this study were to assess the feasibility of ESD in France and to evaluate the complete resection rate at 1 year. PATIENTS ANDMETHODS:
Patients with superficial rectal tumors ≥â10âmm in size were prospectively included in the study at nine French expert centers between February 2010 and June 2012.âThe study was stopped temporarily because of a high complication rate. Study recruitment resumed following remedial action.RESULTS:
A total of 45 patients were included (mean age 67 years; 24 males). The immediate perforation rate was 18â% (nâ=â8), and salvage surgery was not required. Six patients (13â%) had late bleeding, which was treated endoscopically in five patients and surgically in one patient who had required blood transfusion. The mortality rate was zero. The en bloc resection rate was 64â% (29/45), and the curative R0 resection rate was 53â% (24/45). Three patients (7â%) had an invasive tumor (two sm1, one T2). At 1-year follow-up, endoscopic examinations showed complete resection in 38â/43 patients (88â%). At the end of the study, after the remedial action, the en bloc resection rate had increased from 52â% to 82â%, and the perforation rate had decreased significantly from 34â% to 0â%.CONCLUSIONS:
The study reflects the initial prospective experience of ESD in France, and suggests that curative R0 resection rates should increase and complication rates should decrease with experience and corrective actions.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Retais
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Carcinoma
/
Adenoma
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Hemorragia Pós-Operatória
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Dissecação
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Hemorragia Gastrointestinal
/
Perfuração Intestinal
Tipo de estudo:
Observational_studies
Limite:
Aged
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Female
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Humans
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Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Ano de publicação:
2014
Tipo de documento:
Article