Skip to main content
main-content

Tipp

Weitere Artikel dieser Ausgabe durch Wischen aufrufen

28.04.2016 | Ausgabe 12/2016

Surgical Endoscopy 12/2016

Stenosis rates after endoscopic submucosal dissection of large rectal tumors involving greater than three quarters of the luminal circumference

Zeitschrift:
Surgical Endoscopy > Ausgabe 12/2016
Autoren:
Seiichiro Abe, Taku Sakamoto, Hiroyuki Takamaru, Masayoshi Yamada, Takeshi Nakajima, Takahisa Matsuda, Yutaka Saito

Abstract

Background

Endoscopic submucosal dissection (ESD) is a minimally invasive treatment option for large rectal tumors. There are limited data available on stenosis rates following ESD of large rectal lesions. We aimed to evaluate the stenosis rate following ESD of large rectal tumors with rectal mucosal defects greater than three quarters of the circumference.

Methods

We retrospectively identified patients who underwent rectal ESD between January 1998 and July 2014. Patients with rectal mucosal defects greater than three quarters the luminal circumference were included for analysis. Clinicopathologic characteristics, treatment outcomes and adverse events were assessed. Stenosis was defined as an inability to pass a pediatric colonoscope into the sigmoid colon. None of the patients underwent prophylactic balloon dilation.

Results

A total of 363 patients with 370 rectal lesions were treated by ESD. Among these, 26 patients had 26 lesions with rectal mucosal defects greater than three quarters of the luminal circumference. Median tumor size (range) was 80 (47–150) mm. Four lesions (15 %) required between 90 and <100 % circumferential dissection, while complete circumferential ESD was performed in two lesions (8 %). Dissection extended to the anal canal in six patients. The median procedure time was 220 min. En bloc resection and curative resection were achieved in 88.5 and 65.4 %, respectively. Delayed bleeding rates and perforation rates were 7.7 and 0 %, respectively. During a median follow-up period of 9.8 (0–59) months, there were no patients with complaints of constipation or fecal incontinence. One patient (4.2 %) was noted to have rectal stenosis, but was clinically asymptomatic. Endoscopic balloon dilation was not required in any patients.

Conclusions

Stenosis may rarely occur after ESD of large rectal lesions with rectal mucosal defects greater than three quarters of the circumference, even without prophylactic endoscopic balloon dilation.

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

★ PREMIUM-INHALT
e.Med Interdisziplinär

Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Premium-Inhalten der Fachzeitschriften, inklusive eines Print-Abos.

Jetzt abonnieren und bis 25. Juni einen 50 € Amazon-Gutschein sichern.

Weitere Produktempfehlungen anzeigen
Literatur
Über diesen Artikel

Weitere Artikel der Ausgabe 12/2016

Surgical Endoscopy 12/2016Zur Ausgabe
  1. Das kostenlose Testabonnement läuft nach 14 Tagen automatisch und formlos aus. Dieses Abonnement kann nur einmal getestet werden.

Neu im Fachgebiet Chirurgie

12.06.2018 | Klinik aktuell | Nachrichten | Onlineartikel

Kliniken müssen Ärzten mehr bieten als nur Geld

12.06.2018 | IT für Ärzte | Nachrichten | Onlineartikel

Was Robotik in der Medizin leisten kann

12.06.2018 | Klinik aktuell | Nachrichten | Onlineartikel

Entlassmanagement: Die Spielregeln machen Probleme

Mail Icon II Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Chirurgie und bleiben Sie gut informiert – ganz bequem per eMail.

Bildnachweise