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CC BY-NC-ND 4.0 · Endosc Int Open 2020; 08(12): E1832-E1839
DOI: 10.1055/a-1268-7353
Original article

Acceptability of endoscopic submucosal dissection for sessile serrated lesions: comparison with non-sessile serrated lesions

Yuichiro Kuroki
Department of Gastroenterology, Showa University Fujigaoka Hospital, Kanagawa, Japan
,
Toshiyuki Endo
Department of Gastroenterology, Showa University Fujigaoka Hospital, Kanagawa, Japan
,
Kenta Iwahashi
Department of Gastroenterology, Showa University Fujigaoka Hospital, Kanagawa, Japan
,
Naoki Miyao
Department of Gastroenterology, Showa University Fujigaoka Hospital, Kanagawa, Japan
,
Reika Suzuki
Department of Gastroenterology, Showa University Fujigaoka Hospital, Kanagawa, Japan
,
Kunio Asonuma
Department of Gastroenterology, Showa University Fujigaoka Hospital, Kanagawa, Japan
,
Yorimasa Yamamoto
Department of Gastroenterology, Showa University Fujigaoka Hospital, Kanagawa, Japan
,
Masatsugu Nagahama
Department of Gastroenterology, Showa University Fujigaoka Hospital, Kanagawa, Japan
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Abstract

Background and study aims Sessile serrated lesions (SSL) are major precursor lesions of serrated pathway cancers, and appropriate treatment may prevent interval colorectal cancer. Studies have reported the outcomes of endoscopic mucosal resection (EMR) for SSL; however, there are insufficient reports on endoscopic submucosal dissection (ESD). We examined the characteristics and outcomes of SSL and compared them to those of non-SSL in ESD.

Patients and methods We reviewed 370 consecutive cases in 322 patients who underwent colorectal ESD between January 2016 and March 2020 at our hospital. There were 267 0-IIa lesions that were stratified into 41 SSL and 226 non-SSL (intramucosal cancer, adenoma) cases. We used propensity matching to adjust for the variances in the factors affecting treatment between the SSL and non-SSL groups.

Results In the baseline cases, young women and proximal colon tumor location were significantly more common in the SSL group. There were no statistically significant differences between the SSL and non-SSL groups in terms of en bloc resection rate (97.6 % vs. 99.6 %; P = 0.28), R0 resection rate (92.7 % vs. 93.4 %; P = 0.74), perforation (0 % vs. 0.9 %; P > 0.99), and postoperative bleeding (2.4 % vs. 1.8 %; P = 0.56). Thirty-eight pairs were matched using propensity score, and the median dissection speed (12 vs. 7.7 cm2/h; P = 0.0095) was significantly faster in the SSL than in the non-SSL group.

Conclusions ESD for SSL was safely performed, and SSL was smoother to remove than non-SSL. ESD might be an acceptable endoscopic treatment option for SSL.



Publication History

Received: 24 June 2020

Accepted: 03 September 2020

Article published online:
17 November 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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