Diagnostic endoscopic submucosal dissection for colorectal lesions with suspected deep invasion.
Endoscopy
; 55(2): 192-197, 2023 02.
Article
em En
| MEDLINE
| ID: mdl-35649429
ABSTRACT
BACKGROUND:
Endoscopic submucosal dissection (ESD) is potentially a curative treatment for T1 colorectal cancer under certain conditions. The aim of this study was to evaluate the feasibility and effectiveness of ESD for lesions with a suspicion of focal deep invasion.METHODS:
In this retrospective multicenter study, consecutive patients with colorectal neoplasia displaying a focal (< 15âmm) deep invasive pattern (FDIP) that were treated by ESD were included. We excluded ulcerated lesions (Paris III), lesions with distant metastasis, and clearly advanced tumors (tumoral strictures).RESULTS:
124 patients benefited from 126 diagnostic dissection attempts for FDIP lesions. Dissection was feasible in 120/126 attempts (95.2â%) and, where possible, the en bloc and R0 resection rates were 95.8â% (115/120) and 76.7â% (92/120), respectively. Thirty-three resections (26.2â%) were for very low risk tumors, so considered curative, and 38 (30.2â%) were for low risk lesions. Noncurative R0 resections were for lesions with lymphatic or vascular invasion (LVI; nâ=â8), or significant budding (nâ=â9), and LVIâ+âbudding combination (nâ=â4).CONCLUSION:
ESD is feasible and safe for colorectal lesions with an FDIPâ≤â15âmm. It was curative in 26.6â% of patients and could be a valid option for a further 30.6â% of patients with low risk T1 cancers, especially for frail patients with co-morbidities.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Colorretais
/
Ressecção Endoscópica de Mucosa
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
Limite:
Humans
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article