Pocket-creation method facilitates endoscopic submucosal dissection of colorectal laterally spreading tumors, non-granular type.
Background and study aimsThe 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 methodsThe 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.ResultsThe 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).ConclusionESD using PCM achieves a reliable and safe resection of colorectal LST-NG.
Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan.
Hirotsugu
H
Sakamoto
Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan.
Yoshikazu
Y
Hayashi
Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan.
Yoshimasa
Y
Miura
Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan; Shinozaki Medical Clinic, Utsunomiya, Japan.
Satoshi
S
Shinozaki
Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan.
Haruo
H
Takahashi
Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan.
Hisashi
H
Fukuda
Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan.
Masahiro
M
Okada
Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan.
Yuji
Y
Ino
Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan.
Takahito
T
Takezawa
Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan.
Keijiro
K
Sunada
Department of Surgery, Jichi Medical University, Shimotsuke, Japan.
Alan Kawarai
AK
Lefor
Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke, Japan.
Hironori
H
Yamamoto