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Characteristics of positive horizontal margins in patients who underwent colorectal endoscopic submucosal dissection

OBJECTIVES: Endoscopic submucosal dissection (ESD) enables en bloc resection of colorectal neoplasms, but occasionally results in positive horizontal margins (HMs). However, the site of the resected specimen that tends to be positive for HM has not been investigated. We aimed to clarify the characte...

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Autores principales: Kawashima, Kazumasa, Hikichi, Takuto, Onizawa, Michio, Gunji, Naohiko, Watahiki, Yu, Sakuma, Chiharu, Mochimaru, Tomoaki, Murakami, Mai, Suzuki, Osamu, Hashimoto, Yuko, Kobayakawa, Masao, Ohira, Hiromasa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10569401/
https://www.ncbi.nlm.nih.gov/pubmed/37841650
http://dx.doi.org/10.1002/deo2.300
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author Kawashima, Kazumasa
Hikichi, Takuto
Onizawa, Michio
Gunji, Naohiko
Watahiki, Yu
Sakuma, Chiharu
Mochimaru, Tomoaki
Murakami, Mai
Suzuki, Osamu
Hashimoto, Yuko
Kobayakawa, Masao
Ohira, Hiromasa
author_facet Kawashima, Kazumasa
Hikichi, Takuto
Onizawa, Michio
Gunji, Naohiko
Watahiki, Yu
Sakuma, Chiharu
Mochimaru, Tomoaki
Murakami, Mai
Suzuki, Osamu
Hashimoto, Yuko
Kobayakawa, Masao
Ohira, Hiromasa
author_sort Kawashima, Kazumasa
collection PubMed
description OBJECTIVES: Endoscopic submucosal dissection (ESD) enables en bloc resection of colorectal neoplasms, but occasionally results in positive horizontal margins (HMs). However, the site of the resected specimen that tends to be positive for HM has not been investigated. We aimed to clarify the characteristics associated with HMs in lesions resected en bloc with ESD. METHODS: Patients with colorectal neoplasms who underwent en bloc resection with ESD were included in this study. The patients were divided into negative HMs (HM0) and positive or indeterminate HMs (HM1) groups. The characteristics associated with HM1 resection were investigated. In addition, the local recurrence rate during endoscopic follow‐up for >6 months after ESD was observed. RESULTS: In total, 201 lesions were analyzed in 189 patients (HM0, 189 lesions; HM1, 12 lesions). The HM1 group had a significantly larger median lesion diameter (25 vs. 55 mm; p < 0.001) and more lesions with >50% circumference than did the HM0 group (p < 0.001). Furthermore, the prevalence of severe fibrosis was significantly higher in the HM1 group than in the HM0 group (p < 0.001). Positive horizontal sites of the resected specimens were more frequent at the oral and anal sites than at the lateral sites. No local recurrences were observed in either group. CONCLUSIONS: The characteristics associated with HM1 depended on lesion size, particularly lesions with >50% circumference, and submucosal fibrosis.
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spelling pubmed-105694012023-10-13 Characteristics of positive horizontal margins in patients who underwent colorectal endoscopic submucosal dissection Kawashima, Kazumasa Hikichi, Takuto Onizawa, Michio Gunji, Naohiko Watahiki, Yu Sakuma, Chiharu Mochimaru, Tomoaki Murakami, Mai Suzuki, Osamu Hashimoto, Yuko Kobayakawa, Masao Ohira, Hiromasa DEN Open Original Articles OBJECTIVES: Endoscopic submucosal dissection (ESD) enables en bloc resection of colorectal neoplasms, but occasionally results in positive horizontal margins (HMs). However, the site of the resected specimen that tends to be positive for HM has not been investigated. We aimed to clarify the characteristics associated with HMs in lesions resected en bloc with ESD. METHODS: Patients with colorectal neoplasms who underwent en bloc resection with ESD were included in this study. The patients were divided into negative HMs (HM0) and positive or indeterminate HMs (HM1) groups. The characteristics associated with HM1 resection were investigated. In addition, the local recurrence rate during endoscopic follow‐up for >6 months after ESD was observed. RESULTS: In total, 201 lesions were analyzed in 189 patients (HM0, 189 lesions; HM1, 12 lesions). The HM1 group had a significantly larger median lesion diameter (25 vs. 55 mm; p < 0.001) and more lesions with >50% circumference than did the HM0 group (p < 0.001). Furthermore, the prevalence of severe fibrosis was significantly higher in the HM1 group than in the HM0 group (p < 0.001). Positive horizontal sites of the resected specimens were more frequent at the oral and anal sites than at the lateral sites. No local recurrences were observed in either group. CONCLUSIONS: The characteristics associated with HM1 depended on lesion size, particularly lesions with >50% circumference, and submucosal fibrosis. John Wiley and Sons Inc. 2023-10-12 /pmc/articles/PMC10569401/ /pubmed/37841650 http://dx.doi.org/10.1002/deo2.300 Text en © 2023 The Authors. DEN Open published by John Wiley & Sons Australia, Ltd on behalf of Japan Gastroenterological Endoscopy Society. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Kawashima, Kazumasa
Hikichi, Takuto
Onizawa, Michio
Gunji, Naohiko
Watahiki, Yu
Sakuma, Chiharu
Mochimaru, Tomoaki
Murakami, Mai
Suzuki, Osamu
Hashimoto, Yuko
Kobayakawa, Masao
Ohira, Hiromasa
Characteristics of positive horizontal margins in patients who underwent colorectal endoscopic submucosal dissection
title Characteristics of positive horizontal margins in patients who underwent colorectal endoscopic submucosal dissection
title_full Characteristics of positive horizontal margins in patients who underwent colorectal endoscopic submucosal dissection
title_fullStr Characteristics of positive horizontal margins in patients who underwent colorectal endoscopic submucosal dissection
title_full_unstemmed Characteristics of positive horizontal margins in patients who underwent colorectal endoscopic submucosal dissection
title_short Characteristics of positive horizontal margins in patients who underwent colorectal endoscopic submucosal dissection
title_sort characteristics of positive horizontal margins in patients who underwent colorectal endoscopic submucosal dissection
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10569401/
https://www.ncbi.nlm.nih.gov/pubmed/37841650
http://dx.doi.org/10.1002/deo2.300
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