Report on the application of endoscopic intermuscular dissection for diagnostic resection of early rectal cancer
	    		
		   		
		   			
		   		
	    	
    	 
    	10.3760/cma.j.cn441530-20240314-00098
   		
        
        	
        		- VernacularTitle:内镜肌层间剥离术在早期直肠癌诊断性切除中的一例应用报告
 
        	
        	
        	
        		- Author:
	        		
		        		
		        		
			        		Dejun FAN
			        		
			        		
			        		
			        			1
			        			
			        		
			        		
			        		
			        		
			        		;
		        		
		        		
		        		
			        		Lingyu HUANG
			        		
			        		;
		        		
		        		
		        		
			        		Jingwen QI
			        		
			        		;
		        		
		        		
		        		
			        		Qiuning WU
			        		
			        		;
		        		
		        		
		        		
			        		Xianhe KONG
			        		
			        		;
		        		
		        		
		        		
			        		Chujun LI
			        		
			        		
		        		
		        		
		        		
		        		
		        			
			        		
			        		Author Information
			        		
		        		
		        		
			        		
			        		
			        			1. 中山大学附属第六医院消化内镜科,广州 510655
			        		
		        		
	        		
        		 
        	
        	
        	
        	
        		- Keywords:
        			
	        			
	        				
	        				
			        		
				        		Rectal neoplasms,early;
			        		
			        		
			        		
				        		Endoscopic intermuscular dissection;
			        		
			        		
			        		
				        		Diagnostic resection
			        		
			        		
	        			
        			
        		
 
        	
            
            
            	- From:
	            		
	            			Chinese Journal of Gastrointestinal Surgery
	            		
	            		 2024;27(6):630-633
	            	
            	
 
            
            
            	- CountryChina
 
            
            
            	- Language:Chinese
 
            
            
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		        	Abstract:
			       	
			       		
				        
				        	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.