Endoscopic submucosal dissection in the practice of a coloproctological hospital. The first results of a single-center trial

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BACKGROUND

The advantage of endoscopic mucosectomy with submucosal dissection (ESD) is the possibility of achieving “en bloc” resection with a lower rate of local relapses compared to partial endoscopic mucosal resection. When analyzing domestic and international publications according the treatment of early colon cancer, there are contradictions in terms of indications and contraindications for this method of treatment. In our opinion, there are not enough studies evaluating the results of the effectiveness of this intervention.

OBJECTIVE

To present the experience of treating patients with benign and malignant tumors using the method of mucosectomy with dissection in the submucosal layer, carried out in the coloproctology hospital of Sechenov University.

MATERIAL AND METHODS

The experience of treating 156 patients with 157 epithelial neoplasms of the colon and rectum by endoscopic submucosal dissection was analyzed.

RESULTS

Mean age of patients was 64.3±11.4 (M±SD); The average neoplasm size was 44.5±2.9 mm (M±SD); 38.9—50.3 (95% CI). Mean operation time 141.03±11.89 (M±SD); 118.1—163.8 (95% CI). The efficiency of «en bloc» resections and the percentage of complete «en bloc» resections (histologically) were 87.2% (137/157) and 83.4% (131/157) respectively, and the rate of radical (R0) resection was 79% (124/157).

CONCLUSIONS

In our study, 79% of patients received radical endoscopic treatment with a complication rate of 9.4% and a mortality rate of 0%. The obtained results, in general, do not differ significantly from international data, and allow us to state that ESD is a safe and reliable organ-preserving method for the removal of large epithelial neoplasms in the colon.

Keywords:

colon

histology

endoscopic submucosal dissection

endoscopic intermuscular resection

Authors:

Fedorenko A.A.

Sechenov First Moscow State Medical University (Sechenov University)

ORCID: 0000-0002-1792-5638

Pavlov P.V.

Sechenov First Moscow State Medical University (Sechenov University)

ORCID: 0000-0002-4391-5441

Kiryukhin A.P.

Sechenov First Moscow State Medical University (Sechenov University)

ORCID: 0000-0001-5685-8784

Tertychnyi A.S.

I.M. Sechenov First Moscow State Medical University (Sechenov University) of the Ministry of Health of Russia

ORCID: 0000-0001-5635-6100

Received:

17.11.2022

Accepted:

03.10.2023

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