Outcomes of endoscopic submucosal dissection for different subtypes of colorectal laterally spreading tumors
10.3760/cma.j.issn.1007-5232.2012.08.002
- VernacularTitle:内镜黏膜下剥离术治疗不同亚型结直肠侧向发育型肿瘤的临床与病理研究
- Author:
Meidong XU
;
Xiaoyun WANG
;
Pinghong ZHOU
;
Liqing YAO
;
Yunshi ZHONG
;
Yiqun ZHANG
;
Weifeng CHEN
;
Lili MA
;
Wenzheng QING
;
Jianwei HU
- Publication Type:Journal Article
- Keywords:
Colorectal neoplasms;
Isoforms;
Laterally spreading tumor;
Endoscopic submucosal dissection
- From:
Chinese Journal of Digestive Endoscopy
2012;29(8):422-428
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinicopathological features of specific subtypes of laterally spreading tumor (LST) and assess the outcomes of endoscopic submucosal dissection (ESD) based upon differentiation status.Methods A total of 174 cases of colorectal LST,treated with ESD between January 2007 and April 2011,were divided into granular type (LST-G) and non-granular type ( LST-NG),and further divided into 4 subtypes,including homogeneous granular,nodular mixed,flat elevated and pseudo-depressed types.Clinicopathological data and ESD parameters were compared between the four subtypes.Results Nodular mixed tumors were larger than homogeneous tumors,needed longer operation time and were more frequently seen in malignant transformation,high grade intraepithelial neoplasm ( HGIN ) as well as submucosal invasive cancer.So were peeudo-depressed tumors compared with flat elevated ones ( P ＜0.01 ).There was no significant difference between LST-G and LST-NG in the parameters of ESD including en bloc resection rate,complete resection rate and complete cure resection rate.The complications tended to be more frequent in nodular mixed tumors (bleeding rate:4.6％; peroration rate:3.5％ ) and pseudo-depressed tumors ( bleeding rate:11.1％ ; perforation rate 11.1％ ),but there was no severe complication in either homogeneous tumors or fiat elevated tumors.One recurrent pseudo-depressed tumor was found 6 months after ESD treatment.Conclusion The degree of technical difficulty appears higher for nodular mixed and pseudo-depressed tumors than for homogeneous and flat elevated tumors,as is shown in procedure time and complication rate.ESD for these two subtypes should better be performed by experienced endoscopists.Accurate differentiation of the LST lesions is needed in basic and clinical research.
