Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver · 2024
Feasibility, safety and efficacy of endoscopic submucosal dissection for recurrent superficial rectal neoplastic lesions after transanal microsurgery.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Jaafar Ali, Jacques Jeremie, Leblanc Sarah, Legros Romain, Lepilliez Vincent, Berger Arthur, Chabrun Edouard, Le Baleur Yann, Pioche Mathieu, Barret Maximilien, Wallenhorst Timothee, Degand Thibault, Corre Felix, Schaefer Marion, Dray Xavier
Аннотация
BACKGROUND AND AIMS: We aimed to evaluate the feasibility, safety and efficacy of endoscopic submucosal dissection for recurrent rectal neoplastic lesions after transanal microsurgery of superficial rectal neoplasms.
METHODS: Multicenter retrospective study.
MAIN OUTCOMES: recurrence at first endoscopic follow-up, En bloc, R0 and curative resections.
RESULTS: 39 patients were included. 71 % percent of lesions were located in the lower rectum, 57 % reached the pectineal line. 67 % were laterally spreading tumor granular type, 33 % were protruding lesions. Median size was 41 mm (IQR 30 - 60). Median operation time was 70 min (IQR 35 - 97). 92 % were successfully resected en bloc. R0 and curative resection rates were 77 % and 71 %, respectively. Perirectal fat was visualized in 10 patients, none of them required surgery. One significant hematochezia (3 %), two stenosis (6 %) and one untreatable anal incontinence (3 %) occurred. Median hospital stay after endoscopic submucosal dissection was 2 days (IQR 1-2). Median period for the first endoscopy follow-up was 6 months (IQR 4-8). A single post endoscopic submucosal dissection recurrence adenoma was found during follow-up (3 %), occurring after a non-en bloc resection.
CONCLUSION: Endoscopic submucosal dissection is a good option for safely achieving high rates of complete en bloc resection in cases of recurrent superficial rectal tumor after transanal microsurgery.
METHODS: Multicenter retrospective study.
MAIN OUTCOMES: recurrence at first endoscopic follow-up, En bloc, R0 and curative resections.
RESULTS: 39 patients were included. 71 % percent of lesions were located in the lower rectum, 57 % reached the pectineal line. 67 % were laterally spreading tumor granular type, 33 % were protruding lesions. Median size was 41 mm (IQR 30 - 60). Median operation time was 70 min (IQR 35 - 97). 92 % were successfully resected en bloc. R0 and curative resection rates were 77 % and 71 %, respectively. Perirectal fat was visualized in 10 patients, none of them required surgery. One significant hematochezia (3 %), two stenosis (6 %) and one untreatable anal incontinence (3 %) occurred. Median hospital stay after endoscopic submucosal dissection was 2 days (IQR 1-2). Median period for the first endoscopy follow-up was 6 months (IQR 4-8). A single post endoscopic submucosal dissection recurrence adenoma was found during follow-up (3 %), occurring after a non-en bloc resection.
CONCLUSION: Endoscopic submucosal dissection is a good option for safely achieving high rates of complete en bloc resection in cases of recurrent superficial rectal tumor after transanal microsurgery.