| 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IS4-4：Outcomes and factors predictive of technical difficulty in colorectal ESD: subgroup analysis of a prospective cohort study conducted by Japanese Society for Cancer of the Colon and Rectum (JSCCR) |
| 演者 | Y. Takeuchi（Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases） |
| 共同演者 | H. Iishi（Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases）, S. Tanaka（Department of Endoscopy, Hiroshima University） |
| 抄録 | Objective: To assess the outcomes of colorectal ESD and evaluate factors predicting technical difficulty. Design: Outcomes were evaluated in 816 colorectal neoplasms >20mm removed by ESD at 15 institutions in a prospective cohort study conducted by endoscopic resection standardization implementation working group in JSCCR between October 2007 and December 2010. Factors predictive of technical difficulty were evaluated by univariate and multivariate regression analysis. Results: 94% of the lesions were resected en bloc. Perforation occurred in 17 patients (2.1%) and bleeding in 20 (2.2%). Significant predictors of failure of en bloc resection were poor lifting after submucosal injection (odds ratio [OR] 7.46; 95% confidence interval [CI], 3.81-15.24) and low-volume (<30 patients) institution (OR 2.57; 95% CI, 1.38-4.82). Significant predictor of perforation was poor lifting after submucosal injection (OR 5.33; 95% CI, 1.92-15.75). Significant predictors of long (> 3 hour) procedure time were large (>40 mm) tumor size (OR 9.11; 95% CI, 5.26-16.66) and low-volume institution (OR 1.82; 95% CI, 1.13-2.92). Conclusions: The outcomes of colorectal ESD in this trial were satisfactory. Colorectal ESD, especially in low-volume centers, may not be optimal for lesions with poor lifting after submucosal injection and large tumor size (UMIN000001642). |
| 索引用語 | colorectal ESD, colorectal neoplasm |