A Case of Pneumorrhachis and Pneumoscrotum Following Colon Endoscopic Submucosal Dissection

Jang, Mi; Cho, Jin Woong; Oh, Wang Guk; Ko, Sung Jun; Han, Shang Hoon; Baek, Hoon Ki; Lee, Young Jae; Kim, Ji Woong; Cho, Yong Keun; Jung, Gum Mo

doi:10.5217/ir.2013.11.3.208

Cited by 2 publications

(3 citation statements)

References 17 publications

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“…However, when ESD is used for colorectal lesions, it is necessary to thoroughly evaluate the anatomical and histological differences of the colon compared to the stomach. Many studies have reported that the thin wall, sparse muscle layer, and tortuous folds of the colorectum lead to a substantial risk of procedure-related perforation 3456. In addition, severe peritonitis may develop due to intestinal bacteria and feces when perforation occurs 56.…”

Section: Introductionmentioning

confidence: 99%

“…Many studies have reported that the thin wall, sparse muscle layer, and tortuous folds of the colorectum lead to a substantial risk of procedure-related perforation 3456. In addition, severe peritonitis may develop due to intestinal bacteria and feces when perforation occurs 56. Despite these limitations, an increasing number of studies have recently reported that colorectal ESD appears to be an effective and safe technique to achieve complete en bloc resection 378.…”

Section: Introductionmentioning

confidence: 99%

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The submucosal fibrosis: what does it mean for colorectal endoscopic submucosal dissection?

Kim

Han

et al. 2016

Intest Res

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Background/AimsEndoscopic submucosal dissection (ESD) allows removal of colorectal epithelial neoplasms en bloc regardless of size. Colorectal ESD is a difficult procedure because of technical difficulties and risks of complications. This study aimed to assess the relationship between ESD outcome and degree of submucosal fibrosis.MethodsPatients with colorectal tumors undergoing ESD and their medical records were reviewed retrospectively. The degree of submucosal fibrosis was classified into three types. The relationship between ESD outcome and degree of submucosal fibrosis was analyzed.ResultsESD was performed in 158 patients. Thirty-eight cases of F0 (no) fibrosis (24.1%) and 46 cases of F2 (severe) fibrosis (29.1%) were observed. Complete resection was achieved for 138 lesions (87.3%). Multivariate analysis demonstrated that submucosal invasion of tumor and histology of carcinoma were independent risk factors for F2 fibrosis. Severe fibrosis was an independent risk factor for incomplete resection.ConclusionsSevere fibrosis is an important factor related to incomplete resection during colorectal ESD. In cases of severe fibrosis, the rate of complete resection was low even when ESD was performed by an experienced operator. Evaluation of submucosal fibrosis may be helpful to predict the submucosal invasion of tumors and technical difficulties in ESD.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The submucosal fibrosis: what does it mean for colorectal endoscopic submucosal dissection?

Kim

Han

et al. 2016

Intest Res

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“…[7][8][9] ESD is an effective procedure for en-bloc resection and curative resection of large colorectal tumors that are difficult to resect by EMR. [10][11][12][13] However, it requires high-level technical skills and experience in therapeutic endoscopy. It also has a relatively higher rate of perforation and longer procedural time than EMR.…”

Section: Introductionmentioning

confidence: 99%

Chronological Outcomes and Learning Curve of Endoscopic Submucosal Dissection for Colorectal Tumors

Lee

Kim

Park

et al. 2014

Korean J Gastroenterol

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Background/Aims: Endoscopic submucosal dissection (ESD) is an effective procedure for en-bloc curative resection of the colorectal tumor. As it requires high technical skills and experience in therapeutic endoscopy, it is important to understand learning curve of ESD technique. The aim of this study was to retrospectively describe the clinical results of ESD and to evaluate learning curve for the ESD of colorectal tumors. Methods: A total of 90 patients with 90 colorectal neoplasms, who had undergone ESD at a tertiary referral hospital from July 2009 to December 2012, were enrolled. The ESD was performed by a single endoscopist. All ESD cases were divided into three periods: first, cases 1-30; second, cases 31-60; and third, cases 61-90. Results: The en-bloc resection rates in third period (100%) was significantly higher than that of the first (93.3%) and second period (80%) (p=0.025). The perforation rate in third period (0%) also significantly decreased compared with that of the first (13.3%) and second period (20%) (p=0.032). To calibrate the difference of tumor size among periods, proficiency was calculated, as the procedure time per specimen area (min/cm 2 ). The proficiency in third period (4.3) was significantly shorter than that of the first (16.8) and second period (10.2) (p=0.004). Conclusions: The learning curve of colorectal ESD in our study shows that at least 60 cases of ESD have to be conducted to acquire sufficient skill of degree without perforation. (Korean J Gastroenterol 2014;64:198-205)

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A Case of Pneumorrhachis and Pneumoscrotum Following Colon Endoscopic Submucosal Dissection

Cited by 2 publications

References 17 publications

The submucosal fibrosis: what does it mean for colorectal endoscopic submucosal dissection?

The submucosal fibrosis: what does it mean for colorectal endoscopic submucosal dissection?

Chronological Outcomes and Learning Curve of Endoscopic Submucosal Dissection for Colorectal Tumors

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