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Iacopini F, Saito Y, Bella A, et al. Colorectal endoscopic submucosal dissection: predictors and neoplasm-related gradients of difficulty. Endosc Int Open. 2017;5(9):E839-E846doi: 10.1055/s-0043-113566.
Iacopini, F., Saito, Y., Bella, A., Gotoda, T., Rigato, P., Elisei, W., Montagnese, F., Iacopini, G., & Costamagna, G. (2017). Colorectal endoscopic submucosal dissection: predictors and neoplasm-related gradients of difficulty. Endoscopy international open, 5(9), E839-E846. https://doi.org/10.1055/s-0043-113566
Iacopini, Federico, et al. "Colorectal endoscopic submucosal dissection: predictors and neoplasm-related gradients of difficulty." Endoscopy international open vol. 5,9 (2017): E839-E846. doi: https://doi.org/10.1055/s-0043-113566
Iacopini F, Saito Y, Bella A, Gotoda T, Rigato P, Elisei W, Montagnese F, Iacopini G, Costamagna G. Colorectal endoscopic submucosal dissection: predictors and neoplasm-related gradients of difficulty. Endosc Int Open. 2017 Sep;5(9):E839-E846. doi: 10.1055/s-0043-113566. Epub 2017 Sep 12. PMID: 28924587; PMCID: PMC5595579.
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Endosc Int Open. 2017 Sep;5(9):E839-E846. doi: 10.1055/s-0043-113566. Epub 2017 Sep 12.

Colorectal endoscopic submucosal dissection: predictors and neoplasm-related gradients of difficulty.

Endoscopy international open

Federico Iacopini, Yutaka Saito, Antonino Bella, Takuji Gotoda, Patrizia Rigato, Walter Elisei, Fabrizio Montagnese, Giampaolo Iacopini, Guido Costamagna

Affiliations

  1. Gastroenterology Endoscopy Unit, Ospedale S. Giuseppe, Albano Laziale, Rome, Italy.
  2. Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.
  3. National Centre for Epidemiology, Surveillance and Health Promotion, Istituto Superiore di Sanità, Rome, Italy.
  4. Division of Gastroenterology and Hepatology, Nihon University School of Medicine, Tokyo, Japan.
  5. Pathology Unit, Ospedale S. Giuseppe, Marino, Rome, Italy.
  6. Private Practice, Via Merulana, Rome, Italy.
  7. Surgical Endoscopy Unit, Policlinico Agostino Gemelli, Catholic University, Rome, Italy.

PMID: 28924587 PMCID: PMC5595579 DOI: 10.1055/s-0043-113566

Abstract

BACKGROUND AND STUDY AIM:  The role of colorectal endoscopic submucosal dissection (ESD) is standardized in Japan and East Asia, but technical difficulties hinder its diffusion. The aim was to identify predictors of difficulty for each neoplasm type.

METHODS:  A competent operator performed all procedures. ESD difficulty was defined as: en bloc with a slow speed (< 0.07 cm

RESULTS:  A total of 140 ESDs were included: 110 in the colon and 30 in the rectum. Neoplasms were laterally spreading tumors - granular type (LST-G) in 85 cases (61 %); the median longer axis was 30 mm (range 15 - 180 mm); a scar was present in 15 cases (11 %). ESD en bloc resection and difficulty rates were 85 % (n = 94) and 35 % (n = 39) in the colon, and 73 % (n = 22) and 50 % (n = 15) in the rectum (

CONCLUSIONS:  Colonic and rectal ESD difficulty has qualitative differences. Preoperative predictors should be considered to identify the difficulty gradient of each neoplasm type and the appropriate setting for ESD.

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