| 抄録 |
Introduction: ESD has been adopted for early colorectal neoplasia (CRN), however, there are few reports about its results of larger lesion over 50 mm. We have actively performed ESD for such large CRNs by using IT knife and bipolar knife from the safety points of view. Aim & Methods: To evaluate the colorectal ESD outcomes in varying sizes. We acquired data from a prospectively completed database of colorectal ESD before February 2013. In total, 882 large (size > 20 mm) colorectal tumours were resected by ESD in our hospital. We divided these cases into 2 groups: Group A [lesion size, 20 to 49 mm: n=692 (78%)] and Group B [lesion size > 50 mm: 190 (22%)]. We evaluated the en bloc resection rate, associated complications, procedure time, non-curative rate in both groups. Results: En bloc resection rate, perforation rate, and delayed bleeding rate were 91%, 2.3%, and 1.0%, respectively, in Group A, and 86%, 4.2%, and 4.2%, respectively, in Group B. The average procedure time was 85 ± 48 min in Group A and 176 ± 96 min in Group B (P < 0.01), whilst non-curative resection rates were 10.7% and 17.9% (P < 0.01), respectively.Conclusion: ESD appears to be more complicated for large CRNs over 50 mm. These findings suggest the need for skilled physicians and advanced medical facilities for performing this procedure. |
