Clinical outcomes of endoscopic submucosal dissection for colorectal neoplasms: A single-center experience in Southern Taiwan.
<h4>Background and aims</h4>Endoscopic submucosal dissection (ESD) as an advanced endoscopic procedure can be considered for the removal of colorectal lesions with high suspicion of limited submucosal invasion or cannot be optimally removed by snare-based techniques. We aimed to analyze...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2022-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0275723 |
| _version_ | 1798031154232688640 |
|---|---|
| author | Chen-Yu Ko Chih-Chien Yao Yu-Chi Li Lung-Sheng Lu Yeh-Pin Chou Ming-Luen Hu Yi-Chun Chiu Seng-Kee Chuah Wei-Chen Tai |
| author_facet | Chen-Yu Ko Chih-Chien Yao Yu-Chi Li Lung-Sheng Lu Yeh-Pin Chou Ming-Luen Hu Yi-Chun Chiu Seng-Kee Chuah Wei-Chen Tai |
| author_sort | Chen-Yu Ko |
| collection | DOAJ |
| description | <h4>Background and aims</h4>Endoscopic submucosal dissection (ESD) as an advanced endoscopic procedure can be considered for the removal of colorectal lesions with high suspicion of limited submucosal invasion or cannot be optimally removed by snare-based techniques. We aimed to analyze the clinical outcomes of ESD for colorectal neoplasms in our hospital.<h4>Methods</h4>We retrospectively enrolled 230 patients with 244 colorectal neoplasms who received ESD procedures from April 2012 to October 2020 at Kaohsiung Chang Gung Memorial Hospital. Clinicopathological data were collected by chart review. We also recorded ESD-related complications and clinical outcomes.<h4>Results</h4>The average age was 64 years old, with a mean follow-up time of 22.59 months. There was a loss of follow-up in 34 lesions. Most lesions were lateral spreading tumors of the non-granular type. The average ESD time was 51.9 minutes. Nine cases (3.7%) had procedure-related complications, including two intra-procedure perforations (0.8%) and seven delayed bleeding (2.9%) without procedure-related mortality. 241 lesions (98.8%) achieved en-bloc resection, while 207 lesions (84.8%) achieved R0 resection. Most lesions were tubulo-(villous) adenoma. Malignancy included 35 adenocarcinomas and 5 neuroendocrine tumors. No local recurrence was developed during follow-up. Multivariate analysis for long ESD time revealed significance in size ≥ 10 cm2 and endoscopist's experience < 3 years. Pre-ESD endoscopic ultrasound revealed good prediction in discrimination of mucosal (sensitivity: 0.90) and submucosal lesion (specificity: 0.67).<h4>Conclusions</h4>ESD for colorectal neoplasms is an effective and safe technique. Size ≥ 10 cm2 and endoscopist's experience < 3 years were significantly associated with long procedure time. Pre-ESD EUS provided a good prediction for colorectal neoplasms in invasion depth. |
| first_indexed | 2024-04-11T19:51:42Z |
| format | Article |
| id | doaj.art-ba96963a9ef744df921fc85e6cc20aa5 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-11T19:51:42Z |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-ba96963a9ef744df921fc85e6cc20aa52022-12-22T04:06:16ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-011710e027572310.1371/journal.pone.0275723Clinical outcomes of endoscopic submucosal dissection for colorectal neoplasms: A single-center experience in Southern Taiwan.Chen-Yu KoChih-Chien YaoYu-Chi LiLung-Sheng LuYeh-Pin ChouMing-Luen HuYi-Chun ChiuSeng-Kee ChuahWei-Chen Tai<h4>Background and aims</h4>Endoscopic submucosal dissection (ESD) as an advanced endoscopic procedure can be considered for the removal of colorectal lesions with high suspicion of limited submucosal invasion or cannot be optimally removed by snare-based techniques. We aimed to analyze the clinical outcomes of ESD for colorectal neoplasms in our hospital.<h4>Methods</h4>We retrospectively enrolled 230 patients with 244 colorectal neoplasms who received ESD procedures from April 2012 to October 2020 at Kaohsiung Chang Gung Memorial Hospital. Clinicopathological data were collected by chart review. We also recorded ESD-related complications and clinical outcomes.<h4>Results</h4>The average age was 64 years old, with a mean follow-up time of 22.59 months. There was a loss of follow-up in 34 lesions. Most lesions were lateral spreading tumors of the non-granular type. The average ESD time was 51.9 minutes. Nine cases (3.7%) had procedure-related complications, including two intra-procedure perforations (0.8%) and seven delayed bleeding (2.9%) without procedure-related mortality. 241 lesions (98.8%) achieved en-bloc resection, while 207 lesions (84.8%) achieved R0 resection. Most lesions were tubulo-(villous) adenoma. Malignancy included 35 adenocarcinomas and 5 neuroendocrine tumors. No local recurrence was developed during follow-up. Multivariate analysis for long ESD time revealed significance in size ≥ 10 cm2 and endoscopist's experience < 3 years. Pre-ESD endoscopic ultrasound revealed good prediction in discrimination of mucosal (sensitivity: 0.90) and submucosal lesion (specificity: 0.67).<h4>Conclusions</h4>ESD for colorectal neoplasms is an effective and safe technique. Size ≥ 10 cm2 and endoscopist's experience < 3 years were significantly associated with long procedure time. Pre-ESD EUS provided a good prediction for colorectal neoplasms in invasion depth.https://doi.org/10.1371/journal.pone.0275723 |
| spellingShingle | Chen-Yu Ko Chih-Chien Yao Yu-Chi Li Lung-Sheng Lu Yeh-Pin Chou Ming-Luen Hu Yi-Chun Chiu Seng-Kee Chuah Wei-Chen Tai Clinical outcomes of endoscopic submucosal dissection for colorectal neoplasms: A single-center experience in Southern Taiwan. PLoS ONE |
| title | Clinical outcomes of endoscopic submucosal dissection for colorectal neoplasms: A single-center experience in Southern Taiwan. |
| title_full | Clinical outcomes of endoscopic submucosal dissection for colorectal neoplasms: A single-center experience in Southern Taiwan. |
| title_fullStr | Clinical outcomes of endoscopic submucosal dissection for colorectal neoplasms: A single-center experience in Southern Taiwan. |
| title_full_unstemmed | Clinical outcomes of endoscopic submucosal dissection for colorectal neoplasms: A single-center experience in Southern Taiwan. |
| title_short | Clinical outcomes of endoscopic submucosal dissection for colorectal neoplasms: A single-center experience in Southern Taiwan. |
| title_sort | clinical outcomes of endoscopic submucosal dissection for colorectal neoplasms a single center experience in southern taiwan |
| url | https://doi.org/10.1371/journal.pone.0275723 |
| work_keys_str_mv | AT chenyuko clinicaloutcomesofendoscopicsubmucosaldissectionforcolorectalneoplasmsasinglecenterexperienceinsoutherntaiwan AT chihchienyao clinicaloutcomesofendoscopicsubmucosaldissectionforcolorectalneoplasmsasinglecenterexperienceinsoutherntaiwan AT yuchili clinicaloutcomesofendoscopicsubmucosaldissectionforcolorectalneoplasmsasinglecenterexperienceinsoutherntaiwan AT lungshenglu clinicaloutcomesofendoscopicsubmucosaldissectionforcolorectalneoplasmsasinglecenterexperienceinsoutherntaiwan AT yehpinchou clinicaloutcomesofendoscopicsubmucosaldissectionforcolorectalneoplasmsasinglecenterexperienceinsoutherntaiwan AT mingluenhu clinicaloutcomesofendoscopicsubmucosaldissectionforcolorectalneoplasmsasinglecenterexperienceinsoutherntaiwan AT yichunchiu clinicaloutcomesofendoscopicsubmucosaldissectionforcolorectalneoplasmsasinglecenterexperienceinsoutherntaiwan AT sengkeechuah clinicaloutcomesofendoscopicsubmucosaldissectionforcolorectalneoplasmsasinglecenterexperienceinsoutherntaiwan AT weichentai clinicaloutcomesofendoscopicsubmucosaldissectionforcolorectalneoplasmsasinglecenterexperienceinsoutherntaiwan |