Endoscopy 2020; 52(S 01): S86
DOI: 10.1055/s-0040-1704259
ESGE Days 2020 oral presentations
Friday, April 24, 2020 11:00 – 13:00 Unlock en-bloc 2 Liffey Meeting Room 2
© Georg Thieme Verlag KG Stuttgart · New York

ENDOSCOPIC SUBMUCOSAL DISSECTION FOR COLORECTAL (CR-ESD) MALIGNANT POLYPS: RESULTS OF A PROSPECTIVE WESTERN COHORT

H Uchima
1   Hospital Universitari Germans Trias I Pujol, Gastrointestinal Endoscopy, Badalona, Spain
2   Teknon Medical Center, Endoscopy Unit, Barcelona, Spain
,
AH De Tejada
3   Hospital Puerta de Hierro, Madrid, Spain
,
F Múgica
4   Hospital de Donostia, San Sebastian, Spain
,
F Ramos
5   Hospital Universitario HM Montepríncipe, Madrid, Spain
,
E Albeniz
6   Complejo Hospitalario de Navarra, Pamplona, Spain
,
P Rosón
7   Hospital Quirón Salud Malaga, Málaga, Spain
,
J De La Peña
8   Hospital Marqués de Valdecilla, Santander, Spain
,
Á Teran
8   Hospital Marqués de Valdecilla, Santander, Spain
,
J Rodríguez-Sánchez
9   Hospital Universitario 12 de Octubre, Madrid, Spain
,
D García
10   Hospital Universitario Nuestra Señora de Candelaria, Tenerife, Spain
,
AA Tenorio
10   Hospital Universitario Nuestra Señora de Candelaria, Tenerife, Spain
,
A Sánchez-Yagüe
11   Hospital Costa del Sol, Marbella, Spain
,
AD Pozo
9   Hospital Universitario 12 de Octubre, Madrid, Spain
,
C Dolz
12   Son Llatzer, Mallorca, Spain
,
G Fernández-Esparrach
13   Hospital Clínic Barcelona, Barcelona, Spain
,
J Santiago
3   Hospital Puerta de Hierro, Madrid, Spain
,
Os Nogales
14   Hospital Gregorio Marañón, Madrid, Spain
,
A Alvarez
15   Hospital Universitario de Salamanca, Salamanca, Spain
,
H Cortes
16   San Juan de Dios, Santurce, Spain
,
JC Marín-Gabriel
9   Hospital Universitario 12 de Octubre, Madrid, Spain
,
Spanish Group of Endoscopic Resection (GSEED Resección Mucosa) › Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

Also available at
 
 

    Aims To describe the feasibility, technical success, en-bloc resection and complications of CR-ESD for malignant polyps in a western cohort.

    Methods We evaluated all the cases of CR-ESD in malignant polyps (histology showing invasion of submucosa) included between January 2016 and January 2019 in a prospective multicenter spanish database.

    Comparative data according to location was analyzed. Categorical data was compared using Pearson´s-chi-squared-test, and cuantitative data with T student test.

    Results From 851 colorectal ESDs, 58 (6.8 %) cases with submucosal invasion were evaluated.

    Mean age was 68 years-old, being male 72%.

    The locations were rectum n=21 (36%), sigmoid n=10 (17%), descending colon n=8 (13.7%), splenic flexure=2 (3.4%), transverse colon n=4 (7%), hepatic flexure n=3 (5%), ascending colon n=7 (12%), and cecum n=3 (5%).

    Complete CR-ESD of the lesion was achieved in 48 cases (82.76%), En-bloc resection in 41 (70.69%). There were 10 (17%) aborted procedures due to technical reasons (2/10), perforation (2/10) or muscle-retracting-sign (6/10).

    The specimen mean size was 38.3mm x 30.67mm (CI 95% 33.93-42.68 for major axis, and 26.15-35.19 for minor axis).

    Submucosal fibrosis was absent (F0) in 18 cases, and severe (F2) in 23 cases (39.66%).

    There were 3 (5%) delayed bleeding, 10 (17%) intraprocedural perforations and 2 (3.4%) delayed perforations.

    There were a total of 30 (51.7%) surgeries: 19 (63%) due to histology, 10 for aborted ESD and 1 for delayed perforation.

    When comparing the results of CR-ESD for malignant polyps according to location, the en bloc resection was higher in the rectosigmoid compared to the rest of the colon (83,87% vs 55,55% respectively, p=0.018).

    Need for surgery, was lower after ESD in the rectum than in the colon, with 8 surgeries (38%) vs 22 surgeries (59%), Pr=0.029.

    Conclusions CR-ESD for malignant polyps in the distal colon (sigmoid and rectum) shows better results compared to more proximal locations.


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