• We are available for your help 24/7
  • Email: info@isindexing.com, submission@isindexing.com


Paper Details

Endoscopic Mucosal Resection after Circumferential Mucosal Incision of Large Colorectal Tumors:Comparison With Endoscopic Submucosal Dissection

Yosuke Mochizuki1*, Yasuharu Saito1, Osamu Inatomi2, Yoshihide Fujiyama2, Shigeki Bamba2, Mitsuaki Ishida3, Tomoyuki Tsujikawa4, Akira Andoh5

Journal Title:International Journal of Cancer Studies & Research (IJCR)
Abstract


Background: Endoscopic mucosal resection is widely used for treating superficial colorectal carcinomas or premalignant colorectal tumors. Piecemeal resection and local recurrence are frequent with endoscopic mucosal resection for >20-mm-diameter tumors. Endoscopic submucosal dissection, which facilitates en bloc resection of large colorectal tumors, is useful for superficial colorectal tumors. In our hospital, endoscopic mucosal resection after circumferential mucosal incision was used for colorectal tumors with a diameter of 2030 mm. Objective: To determine the efficacy and safety of endoscopic mucosal resection after circumferential mucosalincision. Design: Retrospective clinical trial at a single center Settings: Shiga University of Medical Science Patients: 77 colorectal tumors (69 patients) with a diameter of 2030 mm endoscopically treated between January 2010 and May2012 at Shiga University of Medical Science. Interventions: Endoscopic submucosal dissection and endoscopic mucosal resection after circumferential mucosal incision. Main Outcome Measures: En bloc resection rate, procedure time, complications Results: ESD was associated with longer procedure times compared with C-EMR (p < 0.005). En bloc resection,complete curative resection, and perforation rates were similar in both groups Delayed bleeding was limited tothe ESD group (2.1%). Histopathological analysis revealed that the incidence of adenoma was lower in the ESD group than in the C-EMR group (p = 0). Mucosal cancer was more frequent in the ESD group (p = 0). The nonlifting sign was seen in 16.7% patients with laterally spreading tumors of nongranular type in the en bloc C-EMR group and 100% patients with laterally spreading tumors of nongranular type in the piecemeal C-EMR group (p = 0.035). Limitations: a single-center retrospective studyConclusions: C-EMR and ESD were equally effective for treating colorectal tumors with a diameter of 2030mm.

Download