CC BY-NC-ND 4.0 · Endosc Int Open 2017; 05(02): E123-E129
DOI: 10.1055/s-0042-122778
Original article
Eigentümer und Copyright ©Georg Thieme Verlag KG 2017

Pocket-creation method facilitates endoscopic submucosal dissection of colorectal laterally spreading tumors, non-granular type

Hirotsugu Sakamoto
1  Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan
,
Yoshikazu Hayashi
1  Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan
,
Yoshimasa Miura
1  Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan
,
Satoshi Shinozaki
1  Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan
2  Shinozaki Medical Clinic, Utsunomiya, Japan
,
Haruo Takahashi
1  Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan
,
Hisashi Fukuda
1  Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan
,
Masahiro Okada
1  Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan
,
Yuji Ino
1  Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan
,
Takahito Takezawa
1  Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan
,
Keijiro Sunada
1  Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan
,
Alan Kawarai Lefor
3  Department of Surgery, Jichi Medical University, Shimotsuke, Japan
,
Hironori Yamamoto
1  Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan
› Author Affiliations
Further Information

Publication History

submitted 05 August 2016

accepted after revision 16 November 2016

Publication Date:
13 February 2017 (online)

Abstract

Background and study aims The pocket-creation method (PCM) is a novel strategy for endoscopic submucosal dissection (ESD). The aim of this study is to determine the efficacy of the PCM for colorectal laterally spreading tumors, non-granular type (LST-NG).

Patients and methods The records of 126 consecutive patients with colorectal LST-NG who underwent ESD between April 2012 and July 2015 were retrospectively reviewed. Patients were divided into PCM (n = 73) and conventional method (CM) (n = 53) groups.

Results The en bloc resection rate in the PCM group was significantly higher than in the CM group (100 % [73/73] vs. 92 % [49/53], P = 0.03). The en bloc resection rate with severe fibrosis was higher in the PCM group than in the CM group (100 % [3/3] vs. 60 % [3/5]). The R0 resection rate for the two groups was not statistically significantly different (93 % [68/73] vs. 91 % [48/53], P = 0.74). The perforation rate in the PCM group was lower than in the CM group although not statistically significantly less (0 % 0/73 vs. 4 % 2/53, P = 0.18). For lesions resected en bloc, dissection speed for the PCM group was significantly faster than for the CM group (median [IQR], 19 [13 –24] vs. 14 [10 – 22] mm2/min, P = 0.03).

Conclusion ESD using PCM achieves a reliable and safe resection of colorectal LST-NG.