Prediction and Treatment of Difficult Cases in Colorectal Endoscopic Submucosal Dissection
Purpose. The aim of this study was to examine the characteristics of difficult cases and the learning curve in colorectal endoscopic submucosal dissection (ESD). Methods. We studied 518 colorectal tumors treated by ESD. Patients were divided into 2 groups such as the difficult ESD group and non-diff...
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2013/523084 |
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| author | Yutaka Inada Naohisa Yoshida Munehiro Kugai Kazuhiro Kamada Kazuhiro Katada Kazuhiko Uchiyama Osamu Handa Tomohisa Takagi Hideyuki Konishi Nobuaki Yagi Yuji Naito Naoki Wakabayashi Akio Yanagisawa Yoshito Itoh |
| author_facet | Yutaka Inada Naohisa Yoshida Munehiro Kugai Kazuhiro Kamada Kazuhiro Katada Kazuhiko Uchiyama Osamu Handa Tomohisa Takagi Hideyuki Konishi Nobuaki Yagi Yuji Naito Naoki Wakabayashi Akio Yanagisawa Yoshito Itoh |
| author_sort | Yutaka Inada |
| collection | DOAJ |
| description | Purpose. The aim of this study was to examine the characteristics of difficult cases and the learning curve in colorectal endoscopic submucosal dissection (ESD). Methods. We studied 518 colorectal tumors treated by ESD. Patients were divided into 2 groups such as the difficult ESD group and non-difficult ESD group in view of procedure time and procedure speed, respectively. The clinical features in each group were analyzed, and we also examined cases with severe fibrosis. Furthermore, we divided all cases into 5 periods according to experience of ESDs and investigated the rates of difficult and perforation cases. Results. In view of both procedure time and procedure speed, there were significant differences about mean tumor size, rates of severe fibrosis and perforation, and en bloc resection rate between the two groups. Severe fibrosis was detected in protruding tumors >40 mm in diameter. With respect to the learning curve, the rate of difficult and perforation cases decreased significantly in the late periods compared to the first period. Conclusions. Large tumor size, high rates of severe fibrosis and perforation, and low rate of en bloc resection are related with difficult ESD cases. The increasing of experiences can decrease the rate of difficult cases and perforation. |
| format | Article |
| id | doaj-art-a8b0a8da7bc04cb58dde8b28a8e120d9 |
| institution | Kabale University |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Gastroenterology Research and Practice |
| spelling | doaj-art-a8b0a8da7bc04cb58dde8b28a8e120d92025-02-03T01:23:17ZengWileyGastroenterology Research and Practice1687-61211687-630X2013-01-01201310.1155/2013/523084523084Prediction and Treatment of Difficult Cases in Colorectal Endoscopic Submucosal DissectionYutaka Inada0Naohisa Yoshida1Munehiro Kugai2Kazuhiro Kamada3Kazuhiro Katada4Kazuhiko Uchiyama5Osamu Handa6Tomohisa Takagi7Hideyuki Konishi8Nobuaki Yagi9Yuji Naito10Naoki Wakabayashi11Akio Yanagisawa12Yoshito Itoh13Department of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, JapanDepartment of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, JapanDepartment of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, JapanDepartment of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, JapanDepartment of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, JapanDepartment of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, JapanDepartment of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, JapanDepartment of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, JapanDepartment of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, JapanDepartment of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, JapanDepartment of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, JapanDepartment of Gastroenterology, Otsu City Hospital, Shiga, JapanDepartment of Surgical Pathology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, JapanDepartment of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, JapanPurpose. The aim of this study was to examine the characteristics of difficult cases and the learning curve in colorectal endoscopic submucosal dissection (ESD). Methods. We studied 518 colorectal tumors treated by ESD. Patients were divided into 2 groups such as the difficult ESD group and non-difficult ESD group in view of procedure time and procedure speed, respectively. The clinical features in each group were analyzed, and we also examined cases with severe fibrosis. Furthermore, we divided all cases into 5 periods according to experience of ESDs and investigated the rates of difficult and perforation cases. Results. In view of both procedure time and procedure speed, there were significant differences about mean tumor size, rates of severe fibrosis and perforation, and en bloc resection rate between the two groups. Severe fibrosis was detected in protruding tumors >40 mm in diameter. With respect to the learning curve, the rate of difficult and perforation cases decreased significantly in the late periods compared to the first period. Conclusions. Large tumor size, high rates of severe fibrosis and perforation, and low rate of en bloc resection are related with difficult ESD cases. The increasing of experiences can decrease the rate of difficult cases and perforation.http://dx.doi.org/10.1155/2013/523084 |
| spellingShingle | Yutaka Inada Naohisa Yoshida Munehiro Kugai Kazuhiro Kamada Kazuhiro Katada Kazuhiko Uchiyama Osamu Handa Tomohisa Takagi Hideyuki Konishi Nobuaki Yagi Yuji Naito Naoki Wakabayashi Akio Yanagisawa Yoshito Itoh Prediction and Treatment of Difficult Cases in Colorectal Endoscopic Submucosal Dissection Gastroenterology Research and Practice |
| title | Prediction and Treatment of Difficult Cases in Colorectal Endoscopic Submucosal Dissection |
| title_full | Prediction and Treatment of Difficult Cases in Colorectal Endoscopic Submucosal Dissection |
| title_fullStr | Prediction and Treatment of Difficult Cases in Colorectal Endoscopic Submucosal Dissection |
| title_full_unstemmed | Prediction and Treatment of Difficult Cases in Colorectal Endoscopic Submucosal Dissection |
| title_short | Prediction and Treatment of Difficult Cases in Colorectal Endoscopic Submucosal Dissection |
| title_sort | prediction and treatment of difficult cases in colorectal endoscopic submucosal dissection |
| url | http://dx.doi.org/10.1155/2013/523084 |
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