Clinical short?term and long?term efficacy of endoscopic submucosal dissection in the treatment of early low rectal cancer and precancerous lesions
10.3760/cma.j.issn.1671?0274.2019.07.007
- VernacularTitle:内镜黏膜下剥离术治疗低位直肠早癌及癌前病变临床近期和远期疗效分析
- Author:
Yuan TIAN
1
;
Long RONG
;
Weidong NIAN
;
Xin WANG
;
Yunlong CAI
;
Guanyi LIU
;
Jixin ZHANG
;
Jinyu LIANG
Author Information
1. 北京大学第一医院内镜中心 100034
- Keywords:
Early rectal neoplasms,low;
Precancerous conditions;
Endoscopicsubmucosal dissection
- From:
Chinese Journal of Gastrointestinal Surgery
2019;22(7):639-642
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the short?term and long?term efficacy of endoscopic submucosal dissection (ESD) in the treatment of early low rectal cancer and precancerous lesions. Methods Inclusion criteria: (1) Distance from the lower margin of tumor to the anal was ≤5 cm. (2) Early low rectal cancers were any size rectal epithelial tumors with infiltration depth limited to the mucosa and submucosa, which were diagnosed by postoperative pathology as high?grade intraepithelial neoplasia or adenocarcinoma of the rectum with infiltration depth of intramucosal or submucosal cancer (M or SM stage). (3) Precancerous lesions included adenoma and low?grade intraepithelial neoplasia of the rectum. (4) Patients received ESD treatment. Patients with tumor invasion depth over submucosa by pathology were excluded. From January 2008 to January 2018, 63 patients meeting the above criteria in Peking University First Hospital were enrolled in this descriptive cohort study. The disease characteristics, clinical manifestations, pathological types, treatment time, hospitalization time, en bloc resection rate (resection of the whole lesion), complete resection rate (both the horizontal and vertical incision margins were negative), postoperative complications and follow?up results were analyzed. Cummulative survival rate was calculated by Kaplan?Meier. Results The diameter of the lesion was (29.0 ± 23.4) mm and the distance from the lesion to the anus was (2.7±1.8) cm. The median operation time was 45.0 (range, 10.0 to 360.0) minutes, the median hospitalization time was 3.0 (range, 2.0 to 12.0) days, en bloc resection rate was 100%, complete resection rate was 96.8% (61/63), and 1 case (1.6%) had postoperative bleeding. The follow?up rate was 87.3% (55/63) and the median follow?up time was 57.9 (range, 15.6 to 121.1) months. No local recurrence was found during the follow?up period and the 5?year survival rate was 100%. Conclusion Short?and long?term efficacy of ESD are quite good in the treatment of patients with early low rectal cancer and precancerous lesions.
