Longly-attached cap can contribute to en bloc underwater endoscopic mucosal resection of 20–30 mm colorectal intramucosal lesions
Background and study aims Underwater endoscopic mucosal resection (UEMR) is effective for colorectal intramucosal lesions. The aim of this study was to evaluate whether a longly-attached cap in UEMR improves the en bloc resection rate for 20–30 mm lesions. Patients and methods We performe...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Georg Thieme Verlag KG
2022-12-01
|
| Series: | Endoscopy International Open |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/a-1961-1684 |
| _version_ | 1811198761820487680 |
|---|---|
| author | Hiroyoshi Iwagami Takuji Akamatsu Shinya Ogino Hiroki Morimura Masayuki Shimoyama Tomoko Terashita Shogo Nakano Midori Wakita Takeya Edagawa Takafumi Konishi Yasuki Nakatani Yukitaka Yamashita |
| author_facet | Hiroyoshi Iwagami Takuji Akamatsu Shinya Ogino Hiroki Morimura Masayuki Shimoyama Tomoko Terashita Shogo Nakano Midori Wakita Takeya Edagawa Takafumi Konishi Yasuki Nakatani Yukitaka Yamashita |
| author_sort | Hiroyoshi Iwagami |
| collection | DOAJ |
| description | Background and study aims Underwater endoscopic mucosal resection (UEMR) is effective for colorectal intramucosal lesions. The aim of this study was to evaluate whether a longly-attached cap in UEMR improves the en bloc resection rate for 20–30 mm lesions.
Patients and methods We performed a retrospective study at a tertiary institute. Candidates for the study were systematically retrieved from an endoscopic and pathological database from October 2016 to December 2020. We assessed the procedural outcomes with UEMR for lesions ≥ 20 mm in size and the clinical factors contributing to en bloc resection.
Results A total of 52 colorectal lesions that underwent UEMR were included. The median procedure time was 271 (66–1264) seconds. The en bloc resection rate and R0 resection rate were 75 % and 73 %, respectively. Intraprocedural perforation occurred in one (1.9 %) case, but no bleeding occurred. Delayed bleeding occurred in one (1.9%) case, but no delayed perforation occurred. Regarding tumor size, macroscopic type, tumor location, and the presence or absence of a history of abdominal operation, there was no significant difference between the en bloc resection and piecemeal resection groups. The visibility of the whole lesion, a longly-attached cap, and sessile serrated lesions were more frequently observed in the en bloc resection group than in the piecemeal resection group (P < 0.001, P = 0.01, and P = 0.04, respectively). Multivariate analysis showed that a longly-attached cap was the only independent factor associated with en bloc resection (P = 0.02).
Conclusions A longly-attached cap might contribute to en bloc resection. |
| first_indexed | 2024-04-12T01:36:45Z |
| format | Article |
| id | doaj.art-e355c4c0158746cd99277415516bf3ee |
| institution | Directory Open Access Journal |
| issn | 2364-3722 2196-9736 |
| language | English |
| last_indexed | 2024-04-12T01:36:45Z |
| publishDate | 2022-12-01 |
| publisher | Georg Thieme Verlag KG |
| record_format | Article |
| series | Endoscopy International Open |
| spelling | doaj.art-e355c4c0158746cd99277415516bf3ee2022-12-22T03:53:18ZengGeorg Thieme Verlag KGEndoscopy International Open2364-37222196-97362022-12-011012E1562E156910.1055/a-1961-1684Longly-attached cap can contribute to en bloc underwater endoscopic mucosal resection of 20–30 mm colorectal intramucosal lesionsHiroyoshi Iwagami0Takuji Akamatsu1Shinya Ogino2Hiroki Morimura3Masayuki Shimoyama4Tomoko Terashita5Shogo Nakano6Midori Wakita7Takeya Edagawa8Takafumi Konishi9Yasuki Nakatani10Yukitaka Yamashita11Department of Gastroenterology and Hepatology, Japanese Red Cross Wakayama Medical Center, Wakayama, JapanDepartment of Gastroenterology and Hepatology, Japanese Red Cross Wakayama Medical Center, Wakayama, JapanDepartment of Gastroenterology and Hepatology, Japanese Red Cross Wakayama Medical Center, Wakayama, JapanDepartment of Gastroenterology and Hepatology, Japanese Red Cross Wakayama Medical Center, Wakayama, JapanDepartment of Gastroenterology and Hepatology, Japanese Red Cross Wakayama Medical Center, Wakayama, JapanDepartment of Gastroenterology and Hepatology, Japanese Red Cross Wakayama Medical Center, Wakayama, JapanDepartment of Gastroenterology and Hepatology, Japanese Red Cross Wakayama Medical Center, Wakayama, JapanDepartment of Gastroenterology and Hepatology, Japanese Red Cross Wakayama Medical Center, Wakayama, JapanDepartment of Gastroenterology and Hepatology, Japanese Red Cross Wakayama Medical Center, Wakayama, JapanDepartment of Gastroenterology and Hepatology, Japanese Red Cross Wakayama Medical Center, Wakayama, JapanDepartment of Gastroenterology and Hepatology, Japanese Red Cross Wakayama Medical Center, Wakayama, JapanDepartment of Gastroenterology and Hepatology, Japanese Red Cross Wakayama Medical Center, Wakayama, JapanBackground and study aims Underwater endoscopic mucosal resection (UEMR) is effective for colorectal intramucosal lesions. The aim of this study was to evaluate whether a longly-attached cap in UEMR improves the en bloc resection rate for 20–30 mm lesions. Patients and methods We performed a retrospective study at a tertiary institute. Candidates for the study were systematically retrieved from an endoscopic and pathological database from October 2016 to December 2020. We assessed the procedural outcomes with UEMR for lesions ≥ 20 mm in size and the clinical factors contributing to en bloc resection. Results A total of 52 colorectal lesions that underwent UEMR were included. The median procedure time was 271 (66–1264) seconds. The en bloc resection rate and R0 resection rate were 75 % and 73 %, respectively. Intraprocedural perforation occurred in one (1.9 %) case, but no bleeding occurred. Delayed bleeding occurred in one (1.9%) case, but no delayed perforation occurred. Regarding tumor size, macroscopic type, tumor location, and the presence or absence of a history of abdominal operation, there was no significant difference between the en bloc resection and piecemeal resection groups. The visibility of the whole lesion, a longly-attached cap, and sessile serrated lesions were more frequently observed in the en bloc resection group than in the piecemeal resection group (P < 0.001, P = 0.01, and P = 0.04, respectively). Multivariate analysis showed that a longly-attached cap was the only independent factor associated with en bloc resection (P = 0.02). Conclusions A longly-attached cap might contribute to en bloc resection.http://www.thieme-connect.de/DOI/DOI?10.1055/a-1961-1684 |
| spellingShingle | Hiroyoshi Iwagami Takuji Akamatsu Shinya Ogino Hiroki Morimura Masayuki Shimoyama Tomoko Terashita Shogo Nakano Midori Wakita Takeya Edagawa Takafumi Konishi Yasuki Nakatani Yukitaka Yamashita Longly-attached cap can contribute to en bloc underwater endoscopic mucosal resection of 20–30 mm colorectal intramucosal lesions Endoscopy International Open |
| title | Longly-attached cap can contribute to en bloc underwater endoscopic mucosal resection of 20–30 mm colorectal intramucosal lesions |
| title_full | Longly-attached cap can contribute to en bloc underwater endoscopic mucosal resection of 20–30 mm colorectal intramucosal lesions |
| title_fullStr | Longly-attached cap can contribute to en bloc underwater endoscopic mucosal resection of 20–30 mm colorectal intramucosal lesions |
| title_full_unstemmed | Longly-attached cap can contribute to en bloc underwater endoscopic mucosal resection of 20–30 mm colorectal intramucosal lesions |
| title_short | Longly-attached cap can contribute to en bloc underwater endoscopic mucosal resection of 20–30 mm colorectal intramucosal lesions |
| title_sort | longly attached cap can contribute to en bloc underwater endoscopic mucosal resection of 20 30 mm colorectal intramucosal lesions |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/a-1961-1684 |
| work_keys_str_mv | AT hiroyoshiiwagami longlyattachedcapcancontributetoenblocunderwaterendoscopicmucosalresectionof2030mmcolorectalintramucosallesions AT takujiakamatsu longlyattachedcapcancontributetoenblocunderwaterendoscopicmucosalresectionof2030mmcolorectalintramucosallesions AT shinyaogino longlyattachedcapcancontributetoenblocunderwaterendoscopicmucosalresectionof2030mmcolorectalintramucosallesions AT hirokimorimura longlyattachedcapcancontributetoenblocunderwaterendoscopicmucosalresectionof2030mmcolorectalintramucosallesions AT masayukishimoyama longlyattachedcapcancontributetoenblocunderwaterendoscopicmucosalresectionof2030mmcolorectalintramucosallesions AT tomokoterashita longlyattachedcapcancontributetoenblocunderwaterendoscopicmucosalresectionof2030mmcolorectalintramucosallesions AT shogonakano longlyattachedcapcancontributetoenblocunderwaterendoscopicmucosalresectionof2030mmcolorectalintramucosallesions AT midoriwakita longlyattachedcapcancontributetoenblocunderwaterendoscopicmucosalresectionof2030mmcolorectalintramucosallesions AT takeyaedagawa longlyattachedcapcancontributetoenblocunderwaterendoscopicmucosalresectionof2030mmcolorectalintramucosallesions AT takafumikonishi longlyattachedcapcancontributetoenblocunderwaterendoscopicmucosalresectionof2030mmcolorectalintramucosallesions AT yasukinakatani longlyattachedcapcancontributetoenblocunderwaterendoscopicmucosalresectionof2030mmcolorectalintramucosallesions AT yukitakayamashita longlyattachedcapcancontributetoenblocunderwaterendoscopicmucosalresectionof2030mmcolorectalintramucosallesions |