Endoscopy 2020; 52(S 01): S260-S261
DOI: 10.1055/s-0040-1704815
ESGE Days 2020 ePoster presentations
Thursday, April 23, 2020 09:00 – 17:00 Clinical endoscopic practice ePoster area
© Georg Thieme Verlag KG Stuttgart · New York

EFFECTIVENESS AND SAFETY OF ENDOSCOPIC SUBMUCOSAL DISSECTION OF GASTROINTESTINAL LESIONS: A PROSPECTIVE WESTERN CENTER EXPERIENCE

S Sferrazza
1   Santa Chiara Hospital, Gastroenterology, Trento, Italy
,
M Maida
2   S Elia – Raimondi Hospital, Gastroenterology, Caltanissetta, Italy
,
M Jovani
3   Johns Hopkins Hospital, Gastroenterology and Hepatology, Baltimore, U S A
,
F Vieceli
1   Santa Chiara Hospital, Gastroenterology, Trento, Italy
,
G de Pretis
1   Santa Chiara Hospital, Gastroenterology, Trento, Italy
,
R Maselli
4   Humanitas Research Hospital, Gastroenterology, Milan, Italy
,
A Repici
4   Humanitas Research Hospital, Gastroenterology, Milan, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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Aims Endoscopic submucosal dissection (ESD) allows ‘en-bloc’ resection of superficial gastrointestinal neoplasms, which has implications for complete excision and pathological analysis. This study aimed to assess the effectiveness and safety of ESD as treatment for gastrointestinal lesions in a prospective western cohort.

Methods All consecutive patients undergoing ESD at one Italian tertiary referral centre from August 2017 to October 2019 were prospectively enrolled.

Results 83 patients with undergoing ESD were included in the study. 65% were male, median age was 68 years (IQR 60–79). Overall, 69% of lesions were located in the rectum and in the sigma, 4% in the right colon, 5% in the esophagus and 22% in the stomach. Most lesions (59%) were lateral spreading tumors (LST), while the remaining were polypoid lesions. The most frequent Kudo classification type was IV, observed in 39% of cases. The mean lesion size was 36 ± 14.5 mm.

ESD was feasible in all cases. The median duration of procedures was 100 minutes (IQR 75–125). Complications included perforation in 6/83 cases (7%), minor bleeding within a week from the procedure in 4/83 cases (5%) and transient urinary retention in 1/83 patient (1%). Colonic ESD showed a non-significant higher complication rate compared to esophagogastric ones (17% vs 4%, p = 0.28).

The resulting histology was cancer (43%), high-grade dysplasia (43%), low-grade dysplasia (13%), and neuroendocrine tumor (1%). An R0 resection was achieved in 73/83 (88%) of patients. Budding and angioinvasion were observed both in only 2% of cases.

Deep or lateral margin positivity was more frequent for lesions in the esophagus/stomach compared to colonic ones (33% vs 27%, p = 0.60) and in LST lesions compared to polypoid lesions (39% vs 21%, p = 0.09).

After a median follow-up of 8.4 months, there was only one case of recurrence.

Conclusions Our experience confirmed that ESD is a safe and effective treatment for early gastrointestinal neoplasia.