Clinical efficacy and safety of endoscopic submucosal dissection for early rectal or anal canal lesions involving the dentate line (with video)
10.3760/cma.j.cn321463-20240311-00473
- VernacularTitle:内镜黏膜下剥离术治疗累及齿状线的早期直肠或肛管病变的临床疗效和安全性初探（含视频）
- Author:
Qiang ZHANG
1
;
Limei GU
;
Qide ZHANG
;
Jun XIAO
;
Yuhong ZHOU
;
Tingsheng LING
Author Information
1. 南京中医药大学附属医院 江苏省中医院消化内镜中心，南京 210029
- Keywords:
Rectal neoplasms;
Anal canal;
Dentate line involvement;
Endoscopic submucosal dissection;
Clinical efficacy
- From:
Chinese Journal of Digestive Endoscopy
2024;41(11):901-905
- CountryChina
- Language:Chinese
-
Abstract:
A retrospective analysis was conducted on data of 13 patients with rectal or anal canal lesions involving the dentate line who underwent endoscopic submucosal dissection (ESD) at the Digestive Endoscopy Center of Jiangsu Province Hospital of Chinese Medicine from January 2022 to July 2023. The efficacy and safety of ESD were evaluated. ESD was performed on 14 lesions in 13 patients. The lesions had a length of 1.4 to 12.5 cm and 5.4 cm in average, which were removed entirely in a single session, with an R0 resection rate of 92.31% (12/13). The ESD procedure duration ranged from 35 to 225 minutes, with an average of 88.3 minutes. Anal canal stenosis occurred in 1 case after ESD, which was improved after treatment with anal dilatation. No delayed bleeding, perforation, or other complications occurred. Pathological examination after ESD revealed 6 tubulovillous adenoma, 2 tubular adenoma, 3 tubular adenocarcinoma, and 2 squamous epithelial intraepithelial neoplasia (both 2 lesions were combined with human papillomavirus infection). In one case of tubular adenocarcinoma, the local resection margin showed focal tubulovillous adenoma, while the other cases were negative on lateral margins around and basal margins. The median follow-up period was 7.0 months (range 2 to 13 months), with no local residue, recurrence or metastasis observed. ESD is safe and effective for early rectal or anal canal lesions involving the dentate line, and is worthy of clinical promotion and application.
