| セッション情報 |
International Session4(消化器内視鏡学会・消化器病学会合同)
Achieving high quality colorectal ESD
|
| タイトル |
内IS4-2：ESD for large colorectal tumors
|
| 演者 |
K. Harada（Okayama University Hospital, Department of Gastroenterology） |
| 共同演者 |
H. Okada（Okayama University Hospital, Department of Gastroenterology）, K. Yamamoto（Okayama University Hospital, Department of Gastroenterology） |
| 抄録 |
Background: Endoscopic submucosal dissection (ESD) has allowed us to achieve en bloc specimens of large early stage gastrointestinal (GI) neoplasms. Concerning colorectal tumors, however, trying ESD for 'too' large lesion was not widely-recommended yet. It was because of higher technical demands, longer procedure time and higher complication rate, compared with ESD in other GI tracts. Objective: To assess the therapeutic outcome of colorectal ESD according to tumor size (Group A: equal or smaller than 50mm; Group B: larger than 50mm). Patients: We examined data from 178 consecutive colorectal neoplasms which were removed by means of ESD at the single institution from April 2008 to October 2012. Results: The number of patients in the Group A was 139 and that of the Group B was 39. Median tumor size was 35mm (15-50) vs. 65mm (55-105). Mean operation time was 81±60 vs. 157±80 (min.) (p < 0.001). Additional surgery after ESD due to misdiagnosis of tumor depth was required in nine (6.5%) and three patients (7.7%), respectively. In the en bloc resection rate, perforation rate and postoperative bleeding rate, there were no significant difference between two groups. Only one patient in the Group A underwent emergency surgery because of delayed perforation. Conclusions: ESD for colorectal tumors larger than 50mm was comparable to smaller ones in the outcome of curative resection and adverse event rate. ESD is an acceptable approach for large colorectal tumors as well. |
| 索引用語 |
colorectal ESD, large tumor |
