Outpatient ESD for challenging colorectal lesions: Is it feasible and safe for western countries?
Background and study aims The need for hospital beds during the COVID-19 pandemic almost overwhelmed the health care systems all over the world. Therefore, elective non-life-saving procedures were postponed. We decided to perform all colorectal endoscopic mucosal dissections (ESDs) for challenging l...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Georg Thieme Verlag KG
2021-02-01
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| Series: | Endoscopy International Open |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/a-1333-1736 |
| _version_ | 1819053847816962048 |
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| author | Silvia Pecere Federico Barbaro Lucio Petruzziello Luigi Giovanni Papparella Marco Napoli Ivo Boskoski Guido Costamagna |
| author_facet | Silvia Pecere Federico Barbaro Lucio Petruzziello Luigi Giovanni Papparella Marco Napoli Ivo Boskoski Guido Costamagna |
| author_sort | Silvia Pecere |
| collection | DOAJ |
| description | Background and study aims The need for hospital beds during the COVID-19 pandemic almost overwhelmed the health care systems all over the world. Therefore, elective non-life-saving procedures were postponed. We decided to perform all colorectal endoscopic mucosal dissections (ESDs) for challenging lesions as outpatient procedures, organizing an ad hoc path to management of any delayed post-procedural complications. The aim of the present study was to retrospectively evaluate the feasibility and safety of outpatient ESD for colorectal tumors.
Patients and methods From March 2020 to May 2020, outpatient colorectal ESDs were performed for 15 challenging lesions. We retrospectively investigated feasibility and safety of the procedures, rates of en bloc resection, and complications rates.
Results The mean age of the patients was 66.5 years and 40 % of the them were on antiplatelet/anticoagulation therapy. Median size of removed lesions was 45 mm (range 32–77) and 38 mm (range 24 to 55) Five patients (33 %) had rectal tumors extending to the dentate line and four (26.6 %) were recurrences on a scar of previous endoscopic or surgical local resections. All complications, such as bleeding or visible microperforation, were managed endoscopically and no delayed perforations occurred. One patient had fever (37.5 °C), while three patients complained of anal pain after ESD for a rectal tumor that extended to the dentate line (RTDL); all patients were managed conservatively.
Conclusion Outpatient colorectal ESD is feasible and safe for challenging lesions. It reduces costs of hospitalization but direct access to the endoscopy service to manage potential post-ESD complications should always be guaranteed. |
| first_indexed | 2024-12-21T12:42:14Z |
| format | Article |
| id | doaj.art-e8c4ac4b5f9f4fc8b069160fda61e075 |
| institution | Directory Open Access Journal |
| issn | 2364-3722 2196-9736 |
| language | English |
| last_indexed | 2024-12-21T12:42:14Z |
| publishDate | 2021-02-01 |
| publisher | Georg Thieme Verlag KG |
| record_format | Article |
| series | Endoscopy International Open |
| spelling | doaj.art-e8c4ac4b5f9f4fc8b069160fda61e0752022-12-21T19:03:44ZengGeorg Thieme Verlag KGEndoscopy International Open2364-37222196-97362021-02-010903E438E44210.1055/a-1333-1736Outpatient ESD for challenging colorectal lesions: Is it feasible and safe for western countries?Silvia Pecere0Federico Barbaro1Lucio Petruzziello2Luigi Giovanni Papparella3Marco Napoli4Ivo Boskoski5Guido Costamagna6Fondazione Policlinico Universitario A. Gemelli IRCCS, Digestive Endoscopy Unit, Rome, Italy Fondazione Policlinico Universitario A. Gemelli IRCCS, Digestive Endoscopy Unit, Rome, Italy Fondazione Policlinico Universitario A. Gemelli IRCCS, Digestive Endoscopy Unit, Rome, Italy Fondazione Policlinico Universitario A. Gemelli IRCCS, Digestive Endoscopy Unit, Rome, Italy Fondazione Policlinico Universitario A. Gemelli IRCCS, Digestive Endoscopy Unit, Rome, Italy Fondazione Policlinico Universitario A. Gemelli IRCCS, Digestive Endoscopy Unit, Rome, Italy Fondazione Policlinico Universitario A. Gemelli IRCCS, Digestive Endoscopy Unit, Rome, Italy Background and study aims The need for hospital beds during the COVID-19 pandemic almost overwhelmed the health care systems all over the world. Therefore, elective non-life-saving procedures were postponed. We decided to perform all colorectal endoscopic mucosal dissections (ESDs) for challenging lesions as outpatient procedures, organizing an ad hoc path to management of any delayed post-procedural complications. The aim of the present study was to retrospectively evaluate the feasibility and safety of outpatient ESD for colorectal tumors. Patients and methods From March 2020 to May 2020, outpatient colorectal ESDs were performed for 15 challenging lesions. We retrospectively investigated feasibility and safety of the procedures, rates of en bloc resection, and complications rates. Results The mean age of the patients was 66.5 years and 40 % of the them were on antiplatelet/anticoagulation therapy. Median size of removed lesions was 45 mm (range 32–77) and 38 mm (range 24 to 55) Five patients (33 %) had rectal tumors extending to the dentate line and four (26.6 %) were recurrences on a scar of previous endoscopic or surgical local resections. All complications, such as bleeding or visible microperforation, were managed endoscopically and no delayed perforations occurred. One patient had fever (37.5 °C), while three patients complained of anal pain after ESD for a rectal tumor that extended to the dentate line (RTDL); all patients were managed conservatively. Conclusion Outpatient colorectal ESD is feasible and safe for challenging lesions. It reduces costs of hospitalization but direct access to the endoscopy service to manage potential post-ESD complications should always be guaranteed.http://www.thieme-connect.de/DOI/DOI?10.1055/a-1333-1736 |
| spellingShingle | Silvia Pecere Federico Barbaro Lucio Petruzziello Luigi Giovanni Papparella Marco Napoli Ivo Boskoski Guido Costamagna Outpatient ESD for challenging colorectal lesions: Is it feasible and safe for western countries? Endoscopy International Open |
| title | Outpatient ESD for challenging colorectal lesions: Is it feasible and safe for western countries? |
| title_full | Outpatient ESD for challenging colorectal lesions: Is it feasible and safe for western countries? |
| title_fullStr | Outpatient ESD for challenging colorectal lesions: Is it feasible and safe for western countries? |
| title_full_unstemmed | Outpatient ESD for challenging colorectal lesions: Is it feasible and safe for western countries? |
| title_short | Outpatient ESD for challenging colorectal lesions: Is it feasible and safe for western countries? |
| title_sort | outpatient esd for challenging colorectal lesions is it feasible and safe for western countries |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/a-1333-1736 |
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