| 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IS4-5：Prediction and knack of difficult cases for endoscopic submucosal dissection of colorectal tumors
|
| 演者 |
N. Yoshida（Department of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine） |
| 共同演者 |
N. Yagi（Department of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine）, Y. Naito（Department of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine） |
| 抄録 |
Purpose: The aim of this study was to examine difficult cases and perforation in colorectal ESD.Material and method: We studied 518 cases involving colorectal tumors that were treated by ESD at this institution between 2006 and 2012. Patients were divided into 2 groups (difficult group and non-difficult group) and various clinical features were investigated. A difficult was defined as a case with procedure time of more than 120 minutes. Additionally, we divided the cases into the 5 periods per 100 cases and investigated the rate of difficult cases and perforation. Results: Overall result of ESD was that the mean tumor size was 31.0 mm, mean operation time was 93.6 minutes, rate of en-bloc resection and perforation was 91.5%, and 3.8%. The rate of fibrosis was significantly higher in the difficult group than the non-difficult group (72.0% vs. 41.0%). The perforation rates in the first and fifth period was 11.0% and 1.6%. Additionally, the rates of difficult case in the first case and fifth period were 18.0% and 10.6%. Conclusion: Our study showed that fibrosis were a risk factor for difficult cases in colorectal ESD. In addition, high ESD experience of the endoscopists and the improvement of ESD devices could decrease the rate of perforation and the rate of difficult cases. |
| 索引用語 |
ESD, perforation |
