Colorectal ESD in day surgery.
Colorectal endoscopic submucosal dissection (ESD) was developed in Japan and is growing in popularity in Europe. Patients undergoing a colorectal ESD procedure in Japan are hospitalized for several days. In this study, we investigated the feasibility of colorectal ESD as an outpatient procedure in a European setting.



A prospective cohort of all patients undergoing colorectal ESD at Danderyds Hospital, Stockholm, Sweden from April 2014 to December 2015 were studied. Data on patient demographics, procedural outcome and 30-day readmissions were studied. Data are presented as median (range), mean ± SD or true numbers as appropriate.



A total of 182 patients underwent a colorectal ESD during the study period. Of the 182 these, 11 were scheduled for an in-hospital procedure and of 171 patients scheduled for a day-procedure and 15 were admitted for observation. The remaining 156 patients were discharged after 2-4 h of observation and comprise the study cohort. Mean age was 69 years. Median lesion size was 28 (10-120) mm, and median resection time was 65 (10-360) min. Lesions were located as follows: anal canal 1 (0.6%), rectum 52 (33.3%), sigmoid 17 (10.9%), descending 3 (1.9%), transverse 24 (15.4%), ascending 29 (18.6%), and cecum 30 (19.2%). Eight (5.1%) of the 156 day surgery patients returned for medical attention during the postoperative 30-day period. Three of them were admitted for in-hospital observation. None of the day surgery patients required any surgical intervention.



Uncomplicated colorectal ESD can safely be carried out in a day surgery setting.
Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan.|Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.|Department of Surgery and Urology, Danderyd Hospital, 182 88, Stockholm, Sweden.
Tomohiko
T
Ohya
Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.|Department of Surgery and Urology, Danderyd Hospital, 182 88, Stockholm, Sweden.
Richard
R
Marsk
Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden. klas.pekkari@ds.se.|Department of Surgery and Urology, Danderyd Hospital, 182 88, Stockholm, Sweden. klas.pekkari@ds.se.
Klas
0000-0003-2062-7321
K
Pekkari
D000368:Aged; D000556:Ambulatory Surgical Procedures; D003113:Colonoscopy / Q000379:methods; D000069916:Endoscopic Mucosal Resection / Q000379:methods; D005060:Europe; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012007:Rectum / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome
Colorectal; Day surgery; EMR; ESD; Endoscopy