Endoscopic submucosal dissection in a European setting. A multi-institutional report of a technique in development

Farhat, Said; Chaussade, Stanislas; Ponchon, Thierry; Coumaros, Dimitri; Charachon, Antoine; Barrioz, Thierry; Koch, Stéphane; Houcke, Philippe; Cellier, C.; Heresbach, Denis; Lépilliez, Vincent; Napoléon, Bertrand; Bauret, P.; Coron, Emmanuel; Rhun, Marc Le; Bichard, Philippe; Vaillant, É.; Calazel, A.; Ben-Soussan, Emmanuel; Bellon, Serge; Mangialavori, Luigi; Robin, Françoise; Prat, Frédéric

doi:10.1055/s-0030-1256413

Cited by 152 publications

(114 citation statements)

References 16 publications

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“…En bloc resection rate in colon ESD has been reported about above 90% in Japan (14-16), 70% in Europe (17). In our multicenter study, the en bloc resection rate was 83.8%, similar to Japanese study.…”

Section: Discussionsupporting

confidence: 86%

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Usefulness and feasibility of endoscopic submucosal dissection for colorectal tumor: a nationwide multicenter retrospective study in Korea

Kim

Baek

Kim

et al. 2016

J. Gastrointest. Oncol.

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Background: Detection rate of precursor lesion of colorectal cancer and early colon cancer have recently been rising because of increased screening endoscopy and increased incidence of colorectal cancer.Endoscopic submucosal dissection (ESD) technique has been reported to be useful in the treatment of such superficial lesions in colon. However, nationwide multicenter study for usefulness and feasibility of colorectal and tumor size (without complication 20.5±10.2 mm vs. with complication 25.9±11.7 mm, P=0.027). The short term morbidity rate was 11.0% including 5 hemorrhages (2.6%) and 16 perforations (8.4%). Conclusions:In this study, ESD shows promise as a useful, potentially feasible procedure in colorectal superficial tumor because of high en bloc resection rate and low morbidity rate, especially in small lesions located from descending colon to rectum.

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Section: Discussionsupporting

confidence: 86%

“…The lesions for which en bloc resection could not be achieved located in right colon/transverse colon 17 …”

Section: Curabilitymentioning

confidence: 99%

Usefulness and feasibility of endoscopic submucosal dissection for colorectal tumor: a nationwide multicenter retrospective study in Korea

Kim

Baek

Kim

et al. 2016

J. Gastrointest. Oncol.

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“…It must be said that ESD might overcome this limitation, defining submucosal involvement more precisely. Nevertheless, ESD is rarely performed in Europe as it is considered technically challenging, while it is affected by a consistent rate of complications (29.2 %) and allows a rate of R0 resections of no more than 72.9 % of cases [22]. Considering our data, it would be advisable to resect rectal polyps >2 cm directly by TEM, in order to obtain a correct T stage and possibly a radical minimally invasive treatment.…”

Section: Discussionmentioning

confidence: 91%

Transanal endoscopic microsurgery after endoscopic resection of malignant rectal polyps: a useful technique for indication to radical treatment

et al. 2013

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Background Management of malignant rectal polyps (MRPs) after endoscopic polypectomy (EP) is still debated. It is sometimes difficult to decide whether to simply follow-up (FU) or to treat such a removed lesion. Transanal endoscopic microsurgery (TEM) could have a role both in T staging and in treating MRPs after EP. Methods Patients who underwent a full-thickness TEM within 3 months after an EP between January 2008 and October 2012 were retrospectively analyzed. If post-TEM histology showed locally advanced rectal cancer, patients underwent a total mesorectal excision (TME) within 4-6 weeks. Patients without malignant disease or pT1sm1 cancers at post-TEM histology were followed up every 3 months for 2 years with clinical examination, flexible rectal endoscopy, and neoplastic markers monitoring. Results A total of 39 patients were included. Post-EP histology was adenocarcinoma in 27/39 cases (69.2 %) and adenoma in 12/39. Mean operative time was 64.2 min; no 30-day mortality occurred; 30-day morbidity was 2.7 % (rectal bleeding in 1/39 cases). Post-TEM histology showed a T2 cancer in 5/39 patients, four with and one without a previous cancer diagnosis, who were further treated by TME (four RARs and one APR) and are disease free with a mean FU of 24.2 months. Post-TEM histology showed adenoma in 10/39 cases and fibrosis in 24/39. These patients are disease free with a mean FU of 13 months. Conclusions A full-thickness TEM after EP of MRPs can establish the presence of residual malignant disease and its depth of invasion, precisely defining the indication to TME. In event of benign post-EP histology, TEM must be performed in presence of macroscopic residual disease, in order to obtain an RO resection and finally exclude cancer, while, in absence of macroscopic residual disease, only close FU is required. Keywords Rectal polyps Endoscopic mucosal resection Transanal endoscopic microsurgery Total mesorectal excision Colorectal cancer (CRC) represents the most frequently diagnosed neoplasm in Europe (436,000 new cases/year, i.e. 13.6 % of diagnosed tumors) [1] and accounts for 8 % of deaths for neoplasm in the world and 12.2 % in Europe [2]. With

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“…Other countries in East Asia (e.g., Korea) that have the highest incidence rates of gastric cancer have also obtained almost similarly favorable ESD outcomes (22)(23)(24). In contrast, some investigators from Western countries have reported poor feasibility and a relatively high postoperative complication rate for ESD, probably because these countries have lesser opportunities for acquiring technical skills for performing ESD due to the lower incidence rates of gastric cancer (25)(26)(27). Thus, in order to introduce and standardize ESD in regions where ESD is still in the developmental stage (e.g., European countries), it is necessary to establish an effective training system for ESD in addition to introducing the several advances of ESD (17,18,28,29).…”

Section: Discussionmentioning

confidence: 99%

Process of technical stabilization of gastric endoscopic submucosal dissection at the National Cancer Center in Japan

Suzuki¹,

Oda²,

Sekiguchi³

et al. 2015

Turk J Gastroenterol

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Endoscopic submucosal dissection in a European setting. A multi-institutional report of a technique in development

Abstract: In this early experience, the feasibility of ESD appeared to be good but R0 resection and complication rates did not match those reported by Japanese authors and must be improved by an extended practice.

Cited by 152 publications

References 16 publications

Usefulness and feasibility of endoscopic submucosal dissection for colorectal tumor: a nationwide multicenter retrospective study in Korea

Usefulness and feasibility of endoscopic submucosal dissection for colorectal tumor: a nationwide multicenter retrospective study in Korea

Transanal endoscopic microsurgery after endoscopic resection of malignant rectal polyps: a useful technique for indication to radical treatment

Process of technical stabilization of gastric endoscopic submucosal dissection at the National Cancer Center in Japan

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