Digestive Endoscopy 2014; 26: 552–555
doi: 10.1111/den.12217
Original Article
Retrospective study of technical aspects and complications of endoscopic submucosal dissection for large superficial colorectal tumors Yoshitaka Nawata,1 Kiyoaki Homma1 and Yoshihiro Suzuki2 Departments of 1Therapeutic Endoscopy and 2Gastroenterology, Nihonkai General Hospital, Sakata, Japan Background and Aim: Colorectal endoscopic submucosal dissection (ESD) is widely carried out, but is still considered difficult. In 2010, a tumor size of ≥50 mm and less experience in colorectal ESD were reported as independent risk factors for complications such as perforation, delayed perforation and postoperative bleeding. In order to overcome such difficulties, we developed a scissors-type grasping device and reported the treatment results of a multicenter study. The aim of the present study was to investigate therapeutic outcomes of colorectal ESD of different tumor sizes. Methods: Group A (134 tumors): tumor size 40 mm was >2 h, and lesions measurCorresponding: Yoshitaka Nawata, Department of Therapeutic Endoscopy, Nihonkai General Hospital, 30 Akiho, Sakata, Yamagata 998-0828, Japan. Email: [email protected] Received 2 October 2013; accepted 11 November 2013.
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ing >40 mm should be treated in medical facilities with more experienced staff.5 In order to overcome such difficulties we developed a scissors-type grasping device called the ‘stag beetle (SB) knife Jr’ (Sumitomo Bakelite, Tokyo, Japan) for colorectal ESD and reported the treatment results of a multicenter study, which was equivalent to the data previously reported from a high-volume center in Japan at that time.6 In the present study, we retrospectively investigated the therapeutic outcomes of colorectal ESD in our hospital and examined the validity of our ESD procedure. In addition, we examined whether we could treat large tumors safely and point out that they are risk factors for complications.
METHODS Tumors
F
ROM APRIL 2010, when a highly advanced medical treatment system started at Nihonkai General Hospital, a total of 150 tumors in 145 patients were resected by ESD to July 2013. ESD was carried out by two endoscopists (K.H and Y.N). We analyzed therapeutic outcomes for all 150
© 2014 The Authors Digestive Endoscopy © 2014 Japan Gastroenterological Endoscopy Society
Digestive Endoscopy 2014; 26: 552–555
ESD for large colorectal tumors 553
tumors and divided the tumors into two groups: Group A (134 tumors): tumor size
doi: 10.1111/den.12217
Original Article
Retrospective study of technical aspects and complications of endoscopic submucosal dissection for large superficial colorectal tumors Yoshitaka Nawata,1 Kiyoaki Homma1 and Yoshihiro Suzuki2 Departments of 1Therapeutic Endoscopy and 2Gastroenterology, Nihonkai General Hospital, Sakata, Japan Background and Aim: Colorectal endoscopic submucosal dissection (ESD) is widely carried out, but is still considered difficult. In 2010, a tumor size of ≥50 mm and less experience in colorectal ESD were reported as independent risk factors for complications such as perforation, delayed perforation and postoperative bleeding. In order to overcome such difficulties, we developed a scissors-type grasping device and reported the treatment results of a multicenter study. The aim of the present study was to investigate therapeutic outcomes of colorectal ESD of different tumor sizes. Methods: Group A (134 tumors): tumor size 40 mm was >2 h, and lesions measurCorresponding: Yoshitaka Nawata, Department of Therapeutic Endoscopy, Nihonkai General Hospital, 30 Akiho, Sakata, Yamagata 998-0828, Japan. Email: [email protected] Received 2 October 2013; accepted 11 November 2013.
bs_bs_banner
552
ing >40 mm should be treated in medical facilities with more experienced staff.5 In order to overcome such difficulties we developed a scissors-type grasping device called the ‘stag beetle (SB) knife Jr’ (Sumitomo Bakelite, Tokyo, Japan) for colorectal ESD and reported the treatment results of a multicenter study, which was equivalent to the data previously reported from a high-volume center in Japan at that time.6 In the present study, we retrospectively investigated the therapeutic outcomes of colorectal ESD in our hospital and examined the validity of our ESD procedure. In addition, we examined whether we could treat large tumors safely and point out that they are risk factors for complications.
METHODS Tumors
F
ROM APRIL 2010, when a highly advanced medical treatment system started at Nihonkai General Hospital, a total of 150 tumors in 145 patients were resected by ESD to July 2013. ESD was carried out by two endoscopists (K.H and Y.N). We analyzed therapeutic outcomes for all 150
© 2014 The Authors Digestive Endoscopy © 2014 Japan Gastroenterological Endoscopy Society
Digestive Endoscopy 2014; 26: 552–555
ESD for large colorectal tumors 553
tumors and divided the tumors into two groups: Group A (134 tumors): tumor size
