Therapeutic value of endoscopic submucosal dissection for early stage colorectal cancer and precancerous lesions
10.3760/cma.j.issn.1007-5232.2018.09.002
- VernacularTitle:内镜黏膜下剥离术在早期大肠癌及癌前病变治疗中的价值
- Author:
Lu WU
1
;
Wei ZHOU
;
Yunchao DENG
;
Dongmei YANG
;
Lianlian WU
;
Xiao WEI
;
Zeying JIANG
;
Jieping YU
;
Honggang YU
Author Information
1. 武汉大学人民医院消化内科
- Keywords:
Colorectal neoplasms;
Risk assessment;
Endoscopic submucosal dissection
- From:
Chinese Journal of Digestive Endoscopy
2018;35(9):611-614
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the safety and efficacy of endoscopic submucosal dissection ( ESD) for early stage colorectal cancer and precancerous lesions. Methods Clinical data of 108 patients who received ESD for early stage colorectal cancer and precancerous lesions from December 2016 to June 2017 in Renmin Hospital of Wuhan University were analyzed. The lesion characteristics, postoperative pathological features, intraoperative and postoperative complications and postoperative follow-up outcomes were analyzed. Results The 108 patients all underwent ESD successfully with median operation time of 45 min. The rate of intraoperative perforation and postoperative delayed bleeding was 2. 8％ ( 3/108) and 2. 8％ (3/108), respectively. No postoperative delayed perforation occurred. Postoperative pathology showed that there were 41 cases ( 38. 0％) of tubular adenoma, 4 ( 3. 7％) villous adenoma, 39 ( 36. 1％) villous tubular adenoma [ including 41 ( 38. 0％) low-grade intraepithelial neoplasia and 16 ( 14. 8％) high-grade intraepithelial neoplasia] , 19 ( 17. 6％) adenocarcinoma, and 5 ( 4. 6％) other types. Among the 19 cases of adenocarcinoma, there were 11 cases of well-differentiated, 5 median-differentiated and 3 low-differentiated. The complete resection rate was 100. 0％ and the en bloc resection rate was 92. 3％ ( 100/108) . The mean follow-up time was 8. 1 months, and no recurrence was found during this period. Conclusion ESD is safe and effective in the treatment of early stage colorectal lesions. It is important to improve preoperative assessment, strengthen surgical skills, analyze postoperative pathological features and regularly follow up to guarantee the treatment quality of ESD.
