Background: Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are established techniques for treatment of superficial gastrointestinal neoplasia. Limitations of EMR are low en bloc resection rates for larger lesions, resulting in frequent recurrences. Major disadvantages of ESD are technical difficulty and long procedure times. We evaluated technical feasibility and safety of newly designed devices for en bloc resection of lesions measuring 20-40 mm in a technique called endoscopic submucosal resection (ESR).
Methods: This case series included 93 lesions from different locations (11 stomach, 25 colon, 57 rectum) with a median size of 29 mm (range 10-70). ESR was performed using two novel instruments for circumferential mucosal incision and deep submucosal resection, respectively.
Results: Resection by ESR was feasible in all cases. En bloc and R0 rates were insufficient when ESR was attempted without prior circumferential mucosal incision, but were 70 % and 63 %, respectively, when mucosal incision was done before application of the submucosal resection device. We observed three complications (two delayed bleedings, one microperforation) but no cases of emergency surgery or 30-day mortality.
Conclusions: Results demonstrated feasibility and excellent safety of ESR using two novel devices for en bloc resection of early gastrointestinal neoplasia. The technique offered relative technical ease and high efficacy.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1055/a-1723-3194 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Endoscopic submucosal dissection for superficial ultra-low rectal tumors: outcomes and predictive factors for procedure difficulty.
Am J Cancer Res
December 2024
Department of Ultrasound, The Second People's Hospital, Fujian University of Traditional Chinese Medicine Fuzhou 350003, Fujian, China.
Background: Ultra-low rectal endoscopic submucosal dissection (ESD) presents technical challenges due to anatomical features. The objective of this research was to determine the risk factors linked to unsuccessful curative resections and to create a nomogram predictive model to assess the likelihood of encountering technical challenges.
Methods: Patients with ultra-low rectal tumors received ESD form June 2017 to December 2022 were retrospectively enrolled.
Transcervical resection of myoma (TCRM): Part II.
Taiwan J Obstet Gynecol
January 2025
Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Medicine, Cheng-Hsin General Hospital, Taipei, Taiwan. Electronic address:
In the part I, we have already reported the rationale, efficacy, complication, and limitation of using transcervical resection of myoma (TCRM) in the management of women with symptomatic uterine fibroids, particularly for those belonging to the International Federation of Gynaecology & Obstetrics (FIGO) myoma classification system as FIGO types 0-2. The current review as part II, the discussion will focus on the techniques, tips and complication prevention or management when TCRM is applied in the management of women with symptomatic submucosal myoma. With better understanding for TCRM-related basic knowledge, such as rationale, efficacy, complication, technique review, tips and prevention or management of complications, plus the well-training and carefully performing TCRM through preceding accurate diagnosis, and good and careful preparation and intensive monitoring during operation and using effective strategy to preventing short-term and long-term complications, TCRM can become one of most powerful strategies in offering the less traumatic injury to the uterus, and an effective and safe surgical approach in dealing with women with symptomatic submucosal myoma.
View Article and Find Full Text PDFTranscervical resection of myoma (TCRM): Part I.
Taiwan J Obstet Gynecol
January 2025
Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Medicine, Cheng-Hsin General Hospital, Taipei, Taiwan. Electronic address:
Uterine fibroids occur frequently in women during the reproductive age, and they are rarely associated with clinical meaning because of their benign characteristics and asymptomatic clinical presentation. Sometimes, uterine fibroids are symptomatic and associated with compression syndrome, infertility, chronic pelvic pain and heavy menstrual bleeding. All need further intervention and treatment.
View Article and Find Full Text PDFLong-term outcomes of endoscopic submucosal dissection for T1b colorectal cancer.
J Cancer Res Ther
December 2024
Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, P. R. China.
Background: Endoscopic submucosal dissection (ESD) is a standardized procedure for intramucosal and slightly invasive submucosal colorectal cancers (CRC). However, the role of ESD for T1b (depth of submucosal invasion: ≥1,000 μm) CRC remains unclear. This study aimed to investigate the long-term efficacy and safety of ESD for T1b CRC.
View Article and Find Full Text PDFThe efficacy and safety of submucosal tunneling endoscopic resection in treating large esophageal subepithelial lesions.
Surg Endosc
January 2025
Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-Sen University, Guangdong, China.
Background: Submucosal tunneling endoscopic resection (STER) is considered an effective, safe and minimally invasive treatment for esophageal subepithelial lesions (SELs) with maximal dilameter less than 3.0 cm, yet its efficacy for lesions over 3.0 cm remains unclear.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!