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Efficacy and suitable indication of colorectal endoscopic submucosal dissection using a balloon‐assisted endoscope
BACKGROUND AND AIM: Cases of colorectal endoscopic submucosal dissection (ESD) with poor maneuverability are often encountered. We aimed to evaluate the efficacy of balloon‐assisted endoscopy (BAE) for such cases. METHODS: We confirmed maneuverability preoperatively in 400 consecutive cases of color...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wiley Publishing Asia Pty Ltd
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7144785/ https://www.ncbi.nlm.nih.gov/pubmed/32280763 http://dx.doi.org/10.1002/jgh3.12247 |
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author | Kuroki, Yuichiro Asonuma, Kunio Uehara, Natsumi Endo, Toshiyuki Suzuki, Reika Yamamoto, Yorimasa Nagahama, Masatsugu |
author_facet | Kuroki, Yuichiro Asonuma, Kunio Uehara, Natsumi Endo, Toshiyuki Suzuki, Reika Yamamoto, Yorimasa Nagahama, Masatsugu |
author_sort | Kuroki, Yuichiro |
collection | PubMed |
description | BACKGROUND AND AIM: Cases of colorectal endoscopic submucosal dissection (ESD) with poor maneuverability are often encountered. We aimed to evaluate the efficacy of balloon‐assisted endoscopy (BAE) for such cases. METHODS: We confirmed maneuverability preoperatively in 400 consecutive cases of colorectal ESD performed at a single center from April 2011 to April 2018. A total of 83 deep colon cases judged as having poor maneuverability were retrospectively reviewed; 54 cases underwent BAE with a single balloon endoscope (group B), and 29 cases underwent conventional procedures without BAE (group C). Tumor size, procedure duration, dissection speed, en bloc resection rate, histology, and associated complications were compared between groups. RESULTS: The mean tumor size, tumor invasiveness, fibrosis, and complications did not differ between groups. Although the en bloc resection rate did not differ (both 98%), the groups significantly differed with regard to the R0 resection rate (B: 96%; C: 83%; P = 0.048). Overall, the procedure duration (B: 51 min; C: 70 min; P = 0.17) and dissection speed (B: 19.4 mm(2)/min; C: 17.4 mm(2)/min; P = 0.13) were not significantly different between groups. However, the dissection speed for lesions in the cecum/ascending colon was significantly faster in group B than in group C (B: 22.3 mm(2)/min; C: 11.3 mm(2)/min; P = 0.037). CONCLUSIONS: In cases of colorectal ESD with poor maneuverability, the use of BAE contributed to an improvement in the R0 resection rate. In addition, BAE contributed to a quicker dissection speed for lesions located in the cecum/ascending colon. |
format | Online Article Text |
id | pubmed-7144785 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Wiley Publishing Asia Pty Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-71447852020-04-10 Efficacy and suitable indication of colorectal endoscopic submucosal dissection using a balloon‐assisted endoscope Kuroki, Yuichiro Asonuma, Kunio Uehara, Natsumi Endo, Toshiyuki Suzuki, Reika Yamamoto, Yorimasa Nagahama, Masatsugu JGH Open Original Articles BACKGROUND AND AIM: Cases of colorectal endoscopic submucosal dissection (ESD) with poor maneuverability are often encountered. We aimed to evaluate the efficacy of balloon‐assisted endoscopy (BAE) for such cases. METHODS: We confirmed maneuverability preoperatively in 400 consecutive cases of colorectal ESD performed at a single center from April 2011 to April 2018. A total of 83 deep colon cases judged as having poor maneuverability were retrospectively reviewed; 54 cases underwent BAE with a single balloon endoscope (group B), and 29 cases underwent conventional procedures without BAE (group C). Tumor size, procedure duration, dissection speed, en bloc resection rate, histology, and associated complications were compared between groups. RESULTS: The mean tumor size, tumor invasiveness, fibrosis, and complications did not differ between groups. Although the en bloc resection rate did not differ (both 98%), the groups significantly differed with regard to the R0 resection rate (B: 96%; C: 83%; P = 0.048). Overall, the procedure duration (B: 51 min; C: 70 min; P = 0.17) and dissection speed (B: 19.4 mm(2)/min; C: 17.4 mm(2)/min; P = 0.13) were not significantly different between groups. However, the dissection speed for lesions in the cecum/ascending colon was significantly faster in group B than in group C (B: 22.3 mm(2)/min; C: 11.3 mm(2)/min; P = 0.037). CONCLUSIONS: In cases of colorectal ESD with poor maneuverability, the use of BAE contributed to an improvement in the R0 resection rate. In addition, BAE contributed to a quicker dissection speed for lesions located in the cecum/ascending colon. Wiley Publishing Asia Pty Ltd 2019-08-19 /pmc/articles/PMC7144785/ /pubmed/32280763 http://dx.doi.org/10.1002/jgh3.12247 Text en © 2019 The Authors. JGH Open: An open access journal of gastroenterology and hepatology published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd. This is an open access article under the terms of the http://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 Kuroki, Yuichiro Asonuma, Kunio Uehara, Natsumi Endo, Toshiyuki Suzuki, Reika Yamamoto, Yorimasa Nagahama, Masatsugu Efficacy and suitable indication of colorectal endoscopic submucosal dissection using a balloon‐assisted endoscope |
title | Efficacy and suitable indication of colorectal endoscopic submucosal dissection using a balloon‐assisted endoscope |
title_full | Efficacy and suitable indication of colorectal endoscopic submucosal dissection using a balloon‐assisted endoscope |
title_fullStr | Efficacy and suitable indication of colorectal endoscopic submucosal dissection using a balloon‐assisted endoscope |
title_full_unstemmed | Efficacy and suitable indication of colorectal endoscopic submucosal dissection using a balloon‐assisted endoscope |
title_short | Efficacy and suitable indication of colorectal endoscopic submucosal dissection using a balloon‐assisted endoscope |
title_sort | efficacy and suitable indication of colorectal endoscopic submucosal dissection using a balloon‐assisted endoscope |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7144785/ https://www.ncbi.nlm.nih.gov/pubmed/32280763 http://dx.doi.org/10.1002/jgh3.12247 |
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