ADVANTAGES OF USING THIN ENDOSCOPE-ASSISTED ENDOSCOPIC SUBMUCOSAL DISSECTION TECHNIQUE FOR LARGE COLORECTAL TUMORS

被引:55
作者
Uraoka, Toshio [1 ]
Ishikawa, Shin [2 ]
Kato, Jun [2 ]
Higashi, Reiji [2 ]
Suzuki, Hideyuki [2 ]
Kaji, Eisuke [2 ]
Kuriyama, Motoaki [2 ]
Saito, Shunsuke [2 ]
Akita, Mitsuhiro [2 ]
Hori, Keisuke [2 ]
Harada, Keita [2 ]
Ishiyama, Shuhei [3 ]
Shiode, Junji [3 ]
Kawahara, Yoshiro
Yamamoto, Kazuhide [2 ]
机构
[1] Okayama Univ Hosp, Dept Endoscopy, Kita Ku, Okayama 7008558, Japan
[2] Okayama Univ, Dept Gastroenterol & Hepatol, Grad Sch Med Dent & Pharmaceut Sci, Okayama 7008530, Japan
[3] Okayama Saiseikai Gen Hosp, Okayama, Japan
关键词
colonic neoplasms; colonoscopy; endoscopic submucosal dissection; endoscopy; gastrointestinal; traction system; MUCOSAL RESECTION; GASTRIC TUMORS; NEOPLASMS; CANCER; VIDEOS; KNIFE; MANAGEMENT; EFFICACY; OUTCOMES; TRIAL;
D O I
10.1111/j.1443-1661.2010.00992.x
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background: Our purpose was to evaluate the effectiveness of a newly developed non-invasive traction technique known as thin endoscope-assisted endoscopic submucosal dissection (TEA-ESD) procedure for the removal of colorectal laterally spreading tumors (LST). Patients and Methods: A total of 37 LST located in the rectum and distal sigmoid colons of 37 patients were eligible for outcome analysis. Twenty-one LST were treated with TEA-ESD and were then retrospectively compared to 16 LST that had previously been treated with standard ESD. Tumor size, en bloc resection rate, procedure time, combined number of different electrical surgical knives used during each procedure and associated complications were evaluated in this case-control study. Results: There was no statistically significant difference in tumor size between the TEA-ESD group and the ESD control group (43.6 +/- 16 mm and 42.4 +/- 14 mm, respectively). All LST were successfully resected en bloc in both groups. Procedure duration was shorter for the TEA-ESD group than the ESD control group, although the difference was not statistically significant (96 +/- 53 minutes vs 116 +/- 74 minutes; P = 0.18). The percentage of cases in which only one electrical surgical knife was used during the entire procedure was significantly higher in the TEA-ESD group compared to the ESD control group (85.7% vs 31.3%; P = 0.0005). There were no perforations in the TEA-ESD group while the ESD control group experienced one perforation. At the present time, TEA-ESD is limited to the rectum and distal sigmoid colon. Conclusion: It was technically easier, safer and more cost-effective to perform ESD for LST in the rectum and the distal sigmoid colon using the newly developed TEA-ESD traction technique.
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收藏
页码:186 / 191
页数:6
相关论文
共 28 条
[1]  
Fujii T, 2001, ENDOSCOPY, V33, P1036
[2]   Successful outcomes of a novel endoscopic treatment for GI tumors: endoscopic submucosal dissection with a mixture of high-molecular-weight hyaluronic acid, glycerin, and sugar [J].
Fujishiro, M ;
Yahagi, N ;
Nakamura, M ;
Kakushima, N ;
Kodashima, S ;
Ono, S ;
Kobayashi, K ;
Hashimoto, T ;
Yamamichi, N ;
Tateishi, A ;
Shimizu, Y ;
Oka, M ;
Ogura, K ;
Kawabe, T ;
Ichinose, M ;
Omata, M .
GASTROINTESTINAL ENDOSCOPY, 2006, 63 (02) :243-249
[3]   Endoscopic submucosal dissection for rectal epithelial neoplasia [J].
Fujishiro, M. ;
Yahagi, N. ;
Nakamura, M. ;
Kakushima, N. ;
Kodashima, S. ;
Ono, S. ;
Kobayashi, K. ;
Hashimoto, T. ;
Yamamichi, N. ;
Tateishi, A. ;
Shimizu, Y. ;
Oka, M. ;
Ogura, K. ;
Kawabe, T. ;
Ichinose, M. ;
Omata, M. .
ENDOSCOPY, 2006, 38 (05) :493-497
[4]   Outcomes of endoscopic submucosal dissection for colorectal epithelial neoplasms in 200 consecutive cases [J].
Fujishiro, Mitsuhiro ;
Yahagi, Naohisa ;
Kakushima, Naomi ;
Kodashima, Shinya ;
Muraki, Yosuke ;
Ono, Satoshi ;
Yamamichi, Nobutake ;
Tateishi, Ayako ;
Oka, Masashi ;
Ogura, Keiji ;
Kawabe, Takao ;
Ichinose, Masao ;
Omata, Masao .
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY, 2007, 5 (06) :678-683
[5]   Prospective clinical trial of magnetic-anchor-guided endoscopic submucosal dissection for large early gastric cancer (with videos) [J].
Gotoda, Takuji ;
Oda, Ichiro ;
Tamakawa, Katsunori ;
Ueda, Hirohisa ;
Kobayashi, Toshiaki ;
Kakizoe, Tadao .
GASTROINTESTINAL ENDOSCOPY, 2009, 69 (01) :10-15
[6]   A new technique for gastric endoscopic submucosal dissection: peroral traction-assisted endoscopic submucosal dissection [J].
Jeon, Won Joong ;
You, Young ;
Chae, Hee Bok ;
Park, Seon Mee ;
Youn, Sei Jin .
GASTROINTESTINAL ENDOSCOPY, 2009, 69 (01) :29-33
[7]   Risk management to prevent perforation during endoscopic submucosal dissection [J].
Kawahara, Yoshiro ;
Takenaka, Ryuta ;
Okada, Hiroyuki .
DIGESTIVE ENDOSCOPY, 2007, 19 :S9-S13
[8]   ENDOSCOPIC MUCOSAL RESECTION OF FLAT AND DEPRESSED TYPES OF EARLY COLORECTAL-CANCER [J].
KUDO, S .
ENDOSCOPY, 1993, 25 (07) :455-461
[9]   Efficacy of the Invasive/Non-invasive Pattern by Magnifying Chromoendoscopy to Estimate the Depth of Invasion of Early Colorectal Neoplasms [J].
Matsuda, Takahisa ;
Fujii, Takahiro ;
Saito, Yutaka ;
Nakajima, Takeshi ;
Uraoka, Toshio ;
Kobayashi, Nozomu ;
Ikehara, Hisatomo ;
Ikematsu, Hiroaki ;
Fu, Kuang-I ;
Emura, Fabian ;
Ono, Akiko ;
Sano, Yasushi ;
Shimoda, Tadakazu ;
Fujimori, Takahiro .
AMERICAN JOURNAL OF GASTROENTEROLOGY, 2008, 103 (11) :2700-2706
[10]   New endoscopic treatment for intramucosal gastric tumors using an insulated-tip diathermic knife [J].
Ohkuwa, M ;
Hosokawa, K ;
Boku, N ;
Ohtu, A ;
Tajiri, H ;
Yoshida, S .
ENDOSCOPY, 2001, 33 (03) :221-226