The expansion of endoscopic submucosal dissection in France: A prospective nationwide survey

Barret, Maximilien; Lépilliez, Vincent; Coumaros, Dimitri; Chaussade, Stanislas; Leblanc, Sarah; Ponchon, Thierry; Fumex, Fabien; Chabrun, Edouard; Bauret, P.; Cellier, Christophe; Coron, Emmanuel; Bichard, Philippe; Bulois, P.; Charachon, Antoine; Rahmi, Gabriel; Bellon, Serge; Lerhun, Marc; Arpurt, Jean‐Pierre; Koch, Stéphane; Napoléon, Bertrand; Vaillant, É.; Esch, Anouk; Farhat, Said; Robin, Françoise; Kaddour, Nadira; Prat, Frédéric

doi:10.1177/2050640616644392

Cited by 40 publications

(49 citation statements)

References 21 publications

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“…A recent nationwide survey from 14 centers in France performing ESD in the UGIT reported a mean procedure duration of 108.2 ± 62 (range of 37 to 330) minutes, en-bloc resection, and R0 rate 91.7% and 71.2%, respectively [19]. In Taiwan, a multicenter case series reported a median procedure duration of gastric ESD of 92.4 minutes for lesions of a median size of 18 mm, with an en-bloc resection rate of 91% [8].…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, the modest records of procedure duration are indicative of ESD being performed in a low volume setting. The recent large series of ESD in multiple centers in France [19] and a prior study in Nagano [26] suggest that center volume may not necessarily be the sole factor affecting outcomes in ESD. Unlike young Japanese endoscopists who embark on ESD, endoscopists here develop a significant amount of experience in therapeutic endoscopy prior to performing ESD.…”

Section: Discussionmentioning

confidence: 99%

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Endoscopic Submucosal Dissection Outcomes for Gastroesophageal Tumors in Low Volume Units: A Multicenter Survey

Azmi

Khor

et al. 2016

Diagnostic and Therapeutic Endoscopy

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Background and Aims. Endoscopic submucosal dissection (ESD) outcomes have traditionally been reported from high volume centers in East Asia. Data from low volume centers in other parts of Asia remain sparse. Methods. A retrospective survey with a structured questionnaire of 5 tertiary centers in 3 countries in South East Asia was conducted. Details of training and clinical outcomes of ESD cases, with follow-up data from these centers, were analyzed. Results. Seven endoscopists from the 5 centers performed a total of 35 cases of ESD in the upper gastrointestinal tract (UGIT) over a 6-year duration. Details of the lesions excised were as follows: median size was 20 mm, morphologically 20 (68.6%) were flat/depressed and 6 (17.1%) were submucosal, and histologically 27 (77.1%) were neoplastic. The median duration of ESD procedures was 105 minutes, with an en-bloc resection rate of 91.4%. There was 1 (2.9%) case of delayed bleeding, but no perforation nor mortality in any of the cases. The recurrence rate after ESD was 5.7%. A prolonged ESD duration was influenced by a larger size of lesion (25 mm, p = 0.02) but not by factors related to the training experience of endoscopists. Conclusions. ESD in the UGIT is feasible and safe in low volume centers in Asia.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Endoscopic Submucosal Dissection Outcomes for Gastroesophageal Tumors in Low Volume Units: A Multicenter Survey

Azmi

Khor

et al. 2016

Diagnostic and Therapeutic Endoscopy

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“…Notably, one study [23] reported three cases of ileus and another study [33] described 10 cases of electrocoagulation syndrome. Perforation and bleeding rate were not given in two of the studies [30,32]. In the remaining 13 reports median perforation rate was 7% with a range between 0 and 19% ( Table 1).…”

Section: Complications and Follow-upmentioning

confidence: 99%

“…One study was not included because the R0 resection rate of colorectal ESD could not be determined [22]. Thus, after application of our inclusion and exclusion criteria, 15 European full-text studies of colorectal ESD published between 2007 and 2018 were included in this review (Table 1) [15,[23][24][25][26][27][28][29][30][31][32][33][34][35][36]. All these included studies were case series.…”

Section: Literature Searchmentioning

confidence: 99%

European experience of colorectal endoscopic submucosal dissection: a systematic review of clinical efficacy and safety

2019

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Background: Endoscopic submucosal dissection (ESD) is an advanced method allowing en bloc resection of large and complex lesions in colon and rectum. Herein, the European experience of colorectal ESD was systematically reviewed in the medical literature to determine the clinical efficacy and safety of colorectal ESD in Europe. Material and methods: A systematic search of PubMed for full-text studies including more than 20 cases of colorectal ESD emanating from European centres was performed. Data were independently extracted by two authors using predefined data fields, including efficacy and safety. Results: We included 15 studies containing a total of 1404 colorectal ESD cases (41% in the colon) performed between 2007 and 2018. Lesion size was 40 mm (range 24-59 mm) and procedure time was 102 min (range 48-176 min). En bloc resection rate was 83% (range 67-93%) and R0 resection rate was 70% (range 35-91%). Perforation rate was 7% (range 0-19%) and bleeding rate was 5% (range 0-12%). The percentage of ESD cases undergoing emergency surgery was 2% (range 0-6%). Additional elective surgery was performed in 3% of all cases due to histopathological findings showing deep submucosal invasion or more advanced cancer. The recurrence rate was 4% (range 0-12%) after a median follow-up time of 12 months (range 3-24 months). Conclusions: This review shows that ESD is effective and safe for treating large and complex colorectal lesions in Europe although there is room for improvement. Thus, it is important to develop standardized and high-quality educational programs in colorectal ESD in Europe. ARTICLE HISTORY

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“…This becomes evident from studies demonstrating significantly better outcome in the hands of experienced endoscopists irrespective of the Western or Eastern origin. [19][20][21] Data from a large metaanalysis 18 demonstrated that the experience of the center/ operator significantly influenced outcomes of the procedures. Centers performing fewer than two ESDs per month had lower R0 resection rates and higher incidence of adverse events.…”

Section: Endoscopic Submucosal Dissection (Esd)mentioning

confidence: 99%

Future of Endoscopy: Brief review of current and future endoscopic resection techniques for colorectal lesions

Hossain

Alkandari

Bhandari

2019

Digestive Endoscopy

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Endoscopic treatment of colorectal lesions has seen major developments in the last decade. It is now considered curative for intramucosal and superficial submucosal cancers. Endoscopic Mucosal Resection in expert hands has very good outcomes with low complication rates but recurrence and inadequate treatment of early cancers remain an issue. This has led to a technical evolution that can lead to one piece resection of neoplasia. This includes a range of techniques from knife assisted snare resection (KAR), endoscopic submucosal dissection (ESD) to full thickness resections. This article reviews all the resection techniques and the evidence base behind them.

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The expansion of endoscopic submucosal dissection in France: A prospective nationwide survey

Abstract: In this multicenter study, ESD achieved high rates of en bloc resection with a significant trend toward better outcomes over time. Improvements in lesion delineation and characterization are still needed to increase R0 resection rates.

Cited by 40 publications

References 21 publications

Endoscopic Submucosal Dissection Outcomes for Gastroesophageal Tumors in Low Volume Units: A Multicenter Survey

Endoscopic Submucosal Dissection Outcomes for Gastroesophageal Tumors in Low Volume Units: A Multicenter Survey

European experience of colorectal endoscopic submucosal dissection: a systematic review of clinical efficacy and safety

Future of Endoscopy: Brief review of current and future endoscopic resection techniques for colorectal lesions

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