Clinical Endoscopy

  • 제55권5호
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  • Pages.655-664
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  • 2022
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  • 2234-2400(pISSN)
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  • 2234-2443(eISSN)
대한소화기내시경학회 (The Korean Society of Gastrointestinal Endoscopy)
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Efficacy of the pocket-creation method with a traction device in endoscopic submucosal dissection for residual or recurrent colorectal lesions

  • Daisuke Ide (Department of Gastroenterology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research) ;
  • Tomohiko Richard Ohya (Department of Endoscopy, The Jikei University School of Medicine) ;
  • Mitsuaki Ishioka (Department of Gastroenterology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research) ;
  • Yuri Enomoto (Department of Gastroenterology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research) ;
  • Eisuke Nakao (Department of Gastroenterology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research) ;
  • Yuki Mitsuyoshi (Department of Gastroenterology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research) ;
  • Junki Tokura (Department of Gastroenterology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research) ;
  • Keigo Suzuki (Department of Gastroenterology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research) ;
  • Seiichi Yakabi (Department of Gastroenterology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research) ;
  • Chihiro Yasue (Department of Gastroenterology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research) ;
  • Akiko Chino (Department of Gastroenterology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research) ;
  • Masahiro Igarashi (Department of Gastroenterology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research) ;
  • Akio Nakashima (Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine) ;
  • Masayuki Saruta (Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine) ;
  • Shoichi Saito (Department of Gastroenterology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research) ;
  • Junko Fujisaki (Department of Gastroenterology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research)
  • 투고 : 2021.11.26
  • 심사 : 2022.02.04
  • 발행 : 2022.09.30
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초록

Background/Aims: Endoscopic submucosal dissection (ESD) for residual or recurrent colorectal lesions after incomplete resection is challenging because of severe fibrosis. This study aimed to compare the efficacy of the pocket-creation method (PCM) with a traction device (TD) with that of conventional ESD for residual or recurrent colorectal lesions. Methods: We retrospectively studied 72 patients with residual or recurrent colorectal lesions resected using ESD. Overall, 31 and 41 lesions were resected using PCM with TD and conventional ESD methods, respectively. We compared patient background and treatment outcomes between the PCM with TD and conventional ESD groups, respectively. The primary endpoints were en bloc resection and R0 resection rates. The secondary endpoints were the dissection speed and incidence of adverse events. Results: En bloc resection was feasible in all cases with PCM with TD, but failed in 22% of cases of conventional ESD. The R0 resection rates for PCM with TD and conventional ESD were 97% and 66%, respectively. Dissection was significantly faster in the PCM with TD group (13.0 vs. 7.9 mm2/min). Perforation and postoperative bleeding were observed in one patient in each group. Conclusions: PCM with TD is an effective method for treating residual or recurrent colorectal lesions after incomplete resection.

키워드

과제정보

The authors thank all our exceptional colleagues at the Department of Gastroenterology for the clinical management of the patients.

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