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Colorectal endoscopic submucosal dissection using the water pressure method for diverticulum-associated lesions: A case series study (with video)
Background and study aims Colorectal endoscopic submucosal dissection (ESD) of diverticulum-associated lesions is challenging because these lesions require precise excision in narrow spaces. The water pressure method (WPM) uses active water pressure by the waterjet function under saline solution-fi...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Georg Thieme Verlag KG
2023
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10072927/ https://www.ncbi.nlm.nih.gov/pubmed/37025155 http://dx.doi.org/10.1055/a-1961-1800 |
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author | Masunaga, Teppei Kato, Motohiko Sasaki, Motoki Iwata, Kentaro Miyazaki, Kurato Kubosawa, Yoko Mizutani, Mari Takatori, Yusaku Matsuura, Noriko Nakayama, Atsushi Kaoru, Takabayashi Yahagi, Naohisa |
author_facet | Masunaga, Teppei Kato, Motohiko Sasaki, Motoki Iwata, Kentaro Miyazaki, Kurato Kubosawa, Yoko Mizutani, Mari Takatori, Yusaku Matsuura, Noriko Nakayama, Atsushi Kaoru, Takabayashi Yahagi, Naohisa |
author_sort | Masunaga, Teppei |
collection | PubMed |
description | Background and study aims Colorectal endoscopic submucosal dissection (ESD) of diverticulum-associated lesions is challenging because these lesions require precise excision in narrow spaces. The water pressure method (WPM) uses active water pressure by the waterjet function under saline solution-filled conditions. This study aimed to determine the feasibility of WPM for resection of diverticulum-associated lesions. Patients and methods This was a retrospective, observational case series study. We reviewed diverticulum-associated lesions treated by ESD with WPM at our institution between June 2017 and July 2021. Diverticulum-associated lesions were classified as follows: type 1, lesions in contact with or within 3 mm of the edge of a diverticulum; type 2, lesions that partially infiltrated the interior of a diverticulum; and type 3, lesions that infiltrated the interior of and completely covered the diverticulum. We collected data on the clinical characteristics and outcomes of the lesions. Results Seven diverticulum-associated lesions were treated with ESD using WPM. The median lesion size was 37 mm (interquartile range: 25–54 mm). There were three cases of type 1, three cases of type 2, and one case of type 3. Three lesions were resected circumventing the diverticulum, and four lesions involved resection of the diverticulum. The en bloc resection and R0 resection rates were 86 %. One patient had severe fibrosis, which caused perforation, and in another patient, the diverticulum was too deep and narrow to be completely isolated. Conclusions WPM allowed for precise procedures in the diverticulum. The feasibility of WPM has been suggested for diverticulum-associated lesions, although cases have been complex. |
format | Online Article Text |
id | pubmed-10072927 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Georg Thieme Verlag KG |
record_format | MEDLINE/PubMed |
spelling | pubmed-100729272023-04-05 Colorectal endoscopic submucosal dissection using the water pressure method for diverticulum-associated lesions: A case series study (with video) Masunaga, Teppei Kato, Motohiko Sasaki, Motoki Iwata, Kentaro Miyazaki, Kurato Kubosawa, Yoko Mizutani, Mari Takatori, Yusaku Matsuura, Noriko Nakayama, Atsushi Kaoru, Takabayashi Yahagi, Naohisa Endosc Int Open Background and study aims Colorectal endoscopic submucosal dissection (ESD) of diverticulum-associated lesions is challenging because these lesions require precise excision in narrow spaces. The water pressure method (WPM) uses active water pressure by the waterjet function under saline solution-filled conditions. This study aimed to determine the feasibility of WPM for resection of diverticulum-associated lesions. Patients and methods This was a retrospective, observational case series study. We reviewed diverticulum-associated lesions treated by ESD with WPM at our institution between June 2017 and July 2021. Diverticulum-associated lesions were classified as follows: type 1, lesions in contact with or within 3 mm of the edge of a diverticulum; type 2, lesions that partially infiltrated the interior of a diverticulum; and type 3, lesions that infiltrated the interior of and completely covered the diverticulum. We collected data on the clinical characteristics and outcomes of the lesions. Results Seven diverticulum-associated lesions were treated with ESD using WPM. The median lesion size was 37 mm (interquartile range: 25–54 mm). There were three cases of type 1, three cases of type 2, and one case of type 3. Three lesions were resected circumventing the diverticulum, and four lesions involved resection of the diverticulum. The en bloc resection and R0 resection rates were 86 %. One patient had severe fibrosis, which caused perforation, and in another patient, the diverticulum was too deep and narrow to be completely isolated. Conclusions WPM allowed for precise procedures in the diverticulum. The feasibility of WPM has been suggested for diverticulum-associated lesions, although cases have been complex. Georg Thieme Verlag KG 2023-04-04 /pmc/articles/PMC10072927/ /pubmed/37025155 http://dx.doi.org/10.1055/a-1961-1800 Text en The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited. |
spellingShingle | Masunaga, Teppei Kato, Motohiko Sasaki, Motoki Iwata, Kentaro Miyazaki, Kurato Kubosawa, Yoko Mizutani, Mari Takatori, Yusaku Matsuura, Noriko Nakayama, Atsushi Kaoru, Takabayashi Yahagi, Naohisa Colorectal endoscopic submucosal dissection using the water pressure method for diverticulum-associated lesions: A case series study (with video) |
title | Colorectal endoscopic submucosal dissection using the water pressure method for diverticulum-associated lesions: A case series study (with video) |
title_full | Colorectal endoscopic submucosal dissection using the water pressure method for diverticulum-associated lesions: A case series study (with video) |
title_fullStr | Colorectal endoscopic submucosal dissection using the water pressure method for diverticulum-associated lesions: A case series study (with video) |
title_full_unstemmed | Colorectal endoscopic submucosal dissection using the water pressure method for diverticulum-associated lesions: A case series study (with video) |
title_short | Colorectal endoscopic submucosal dissection using the water pressure method for diverticulum-associated lesions: A case series study (with video) |
title_sort | colorectal endoscopic submucosal dissection using the water pressure method for diverticulum-associated lesions: a case series study (with video) |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10072927/ https://www.ncbi.nlm.nih.gov/pubmed/37025155 http://dx.doi.org/10.1055/a-1961-1800 |
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