Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Masunaga, Teppei, Kato, Motohiko, Sasaki, Motoki, Iwata, Kentaro, Miyazaki, Kurato, Kubosawa, Yoko, Mizutani, Mari, Takatori, Yusaku, Matsuura, Noriko, Nakayama, Atsushi, Kaoru, Takabayashi, Yahagi, Naohisa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Georg Thieme Verlag KG 2023
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
_version_ 1785019483754070016
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
work_keys_str_mv AT masunagateppei colorectalendoscopicsubmucosaldissectionusingthewaterpressuremethodfordiverticulumassociatedlesionsacaseseriesstudywithvideo
AT katomotohiko colorectalendoscopicsubmucosaldissectionusingthewaterpressuremethodfordiverticulumassociatedlesionsacaseseriesstudywithvideo
AT sasakimotoki colorectalendoscopicsubmucosaldissectionusingthewaterpressuremethodfordiverticulumassociatedlesionsacaseseriesstudywithvideo
AT iwatakentaro colorectalendoscopicsubmucosaldissectionusingthewaterpressuremethodfordiverticulumassociatedlesionsacaseseriesstudywithvideo
AT miyazakikurato colorectalendoscopicsubmucosaldissectionusingthewaterpressuremethodfordiverticulumassociatedlesionsacaseseriesstudywithvideo
AT kubosawayoko colorectalendoscopicsubmucosaldissectionusingthewaterpressuremethodfordiverticulumassociatedlesionsacaseseriesstudywithvideo
AT mizutanimari colorectalendoscopicsubmucosaldissectionusingthewaterpressuremethodfordiverticulumassociatedlesionsacaseseriesstudywithvideo
AT takatoriyusaku colorectalendoscopicsubmucosaldissectionusingthewaterpressuremethodfordiverticulumassociatedlesionsacaseseriesstudywithvideo
AT matsuuranoriko colorectalendoscopicsubmucosaldissectionusingthewaterpressuremethodfordiverticulumassociatedlesionsacaseseriesstudywithvideo
AT nakayamaatsushi colorectalendoscopicsubmucosaldissectionusingthewaterpressuremethodfordiverticulumassociatedlesionsacaseseriesstudywithvideo
AT kaorutakabayashi colorectalendoscopicsubmucosaldissectionusingthewaterpressuremethodfordiverticulumassociatedlesionsacaseseriesstudywithvideo
AT yahaginaohisa colorectalendoscopicsubmucosaldissectionusingthewaterpressuremethodfordiverticulumassociatedlesionsacaseseriesstudywithvideo