Objective:This report presents the initial outcomes of endoscopic intermuscular dissection (EID), a novel technique introduced by our team for the diagnostic resection of early rectal cancer, focusing on the postoperative status of the vertical margins.Methods:On January 26, 2024, a patient with early rectal cancer (cT1-2N0M0) underwent Endoscopic Intermuscular Dissection. The EID procedure consists of six steps: (1) mucosal incision; (2) submucosal dissection; (3) superficial muscular layer incision; (4) intermuscular dissection; (5) complete tumor removal; (6) wound management.Results:The patient was a 70-year-old male with rectal cancer (cT1-2N0M0). The tumor was located on the left anterior wall of the rectum, approximately 9 cm from the anal margin, and measured 20mm in size. The dissection rate was 2.68 mm2/minute, and the total duration of the surgery was 109 minutes. The patient was successfully discharged on the fifth day after surgery. Pathological examination of the post-endoscopic surgery specimen revealed pT1b, with negative vertical margins. Follow-up after more than one month showed good recovery with no complications such as bleeding, perforation, infection, or stricture occurring. Colonoscopy indicated the presence of a granulation tissue suggestive of inflammation.Conclusion:Endoscopic Intermuscular Dissection for the diagnostic resection of early rectal cancer is potentially safe and may achieve negative vertical margins.

Objective:This report presents the initial outcomes of endoscopic intermuscular dissection (EID), a novel technique introduced by our team for the diagnostic resection of early rectal cancer, focusing on the postoperative status of the vertical margins.Methods:On January 26, 2024, a patient with early rectal cancer (cT1-2N0M0) underwent Endoscopic Intermuscular Dissection. The EID procedure consists of six steps: (1) mucosal incision; (2) submucosal dissection; (3) superficial muscular layer incision; (4) intermuscular dissection; (5) complete tumor removal; (6) wound management.Results:The patient was a 70-year-old male with rectal cancer (cT1-2N0M0). The tumor was located on the left anterior wall of the rectum, approximately 9 cm from the anal margin, and measured 20mm in size. The dissection rate was 2.68 mm2/minute, and the total duration of the surgery was 109 minutes. The patient was successfully discharged on the fifth day after surgery. Pathological examination of the post-endoscopic surgery specimen revealed pT1b, with negative vertical margins. Follow-up after more than one month showed good recovery with no complications such as bleeding, perforation, infection, or stricture occurring. Colonoscopy indicated the presence of a granulation tissue suggestive of inflammation.Conclusion:Endoscopic Intermuscular Dissection for the diagnostic resection of early rectal cancer is potentially safe and may achieve negative vertical margins.

OBJECTIVETo investigate the safety, feasibility, clinical value, indication, and distribution of diagnostic diseases in different age groups of colonoscopy in pediatric patients.

METHODSA retrospective analysis was performed on the data of pediatric patients receiving colonoscopy from April 2013 to June 2016 at The Sixth Affiliated Hospital of Sun Yat-sen University. Pediatric patients were divided into 0-6 years group (n=57) and 7-14 years group (n=172). Indication for colonoscopy, detective events and diagnostic diseases distribution were compared between two groups.

RESULTSA total of 229 pediatric patients (male 157 and female 72) were divided into 0-6 years group (57/229, 24.9%) and 7-14 years group(172/229, 75.1%). The main Indications for colonoscopy included abdominal pain (81/229, 35.4%), hematochezia (64/229, 27.9%), crissum abscess or fistula (40/229, 17.5%). Hematochezia was the most common complaint in 0-6 years group (40/57, 70.2%), while abdominal pain in 7-14 years group (74/172, 43.0%). Completion rate between 0-6 years group and 7-14 years group was not significantly different (87.72% vs. 85.47%, χ=0.181, P=0.671). Only one pediatric patient (1/229, 0.4%) developed transient oxygen desaturation and recovered quickly after oxygen supply and aspiration of sputum. No serious complications such as bleeding, perforation or death occurred. Including 45 pediatric patients in 0-6 years group and 102 pediatric patients in 7-14 years group, a total of 147 pediatric patients (147/229, 64.2%) were found to have colorectal lesions. Inflammatory bowel disease (57/147, 38.8%), colonic polyps (40/147, 27.2%) and other intestinal inflammation (39/147, 26.5%) were the main findings. The most frequent diagnosis in 0-6 years group was colonic polyps (28/57, 49.1%), among them, 25 pediatric patients (25/28, 89.3%) were with the complaint of hematochezia. The most frequent diagnosis in 7-14 years group was Inflammatory bowel disease (54/172, 31.4%), among them, 29 pediatric patients (29/54, 53.7%) were with the complaint of abdominal pain.

CONCLUSIONSPediatric colonoscopy is safe and effective. Hematochezia and abdominal pain are the most common complaints in 0-6 years group and 7-14 years group respectively. Colonic polyps and inflammatory bowel disease are the most frequent diagnosis in 0-6 years group and 7-14 years group respectively.