Factors Predictive of Complete Excision of Large Colorectal Neoplasia Using Hybrid Endoscopic Submucosal Dissection: A KASID Multicenter Study

Factors Predictive of Complete Excision of Large Colorectal Neoplasia Using Hybrid Endoscopic... Background Endoscopic submucosal dissection (ESD) with snaring (hybrid ESD) bridges the gap between ESD and endo- scopic mucosal resection. We evaluated factors predictive of en bloc and complete resection of large colorectal neoplasms using hybrid ESD. Methods This was a prospective clinical study of 78 patients who underwent hybrid ESD for excision of colorectal neoplasms (≥ 2 cm) between May 2015 and September 2016 at six university hospitals. We evaluated lesion and patient characteristics, endoscopist experience level (< 50 or ≥ 50 cases with colorectal ESD), and technical factors such as concurrent fibrosis, completion of a circumferential incision, degree of submucosal dissection (< 50 or ≥ 50%), and visualization during snaring (< 50 or ≥ 50%). Results Multivariate analyses showed that the en bloc resection rate was significantly related to the degree of visualization during snaring (odds ratio (OR) 7.811, 95% confidence interval [CI] 1.722–35.426; p = 0.008) and the presence of fibrosis (OR 0.258, 95% CI 0.68–0.993; p = 0.049). The complete resection rate was significantly related to the colorectal ESD endoscopist skill level (OR 5.626, 95% CI 1.485–21.313; p = 0.011) and gross lesion type (OR 0.145, 95% CI 0.022–0.936; p = 0.042). When all three technical factors, http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Digestive Diseases and Sciences Springer Journals

Factors Predictive of Complete Excision of Large Colorectal Neoplasia Using Hybrid Endoscopic Submucosal Dissection: A KASID Multicenter Study

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Publisher
Springer US
Copyright
Copyright © 2018 by Springer Science+Business Media, LLC, part of Springer Nature
Subject
Medicine & Public Health; Gastroenterology; Hepatology; Oncology; Transplant Surgery; Biochemistry, general
ISSN
0163-2116
eISSN
1573-2568
D.O.I.
10.1007/s10620-018-5140-2
Publisher site
See Article on Publisher Site

Abstract

Background Endoscopic submucosal dissection (ESD) with snaring (hybrid ESD) bridges the gap between ESD and endo- scopic mucosal resection. We evaluated factors predictive of en bloc and complete resection of large colorectal neoplasms using hybrid ESD. Methods This was a prospective clinical study of 78 patients who underwent hybrid ESD for excision of colorectal neoplasms (≥ 2 cm) between May 2015 and September 2016 at six university hospitals. We evaluated lesion and patient characteristics, endoscopist experience level (< 50 or ≥ 50 cases with colorectal ESD), and technical factors such as concurrent fibrosis, completion of a circumferential incision, degree of submucosal dissection (< 50 or ≥ 50%), and visualization during snaring (< 50 or ≥ 50%). Results Multivariate analyses showed that the en bloc resection rate was significantly related to the degree of visualization during snaring (odds ratio (OR) 7.811, 95% confidence interval [CI] 1.722–35.426; p = 0.008) and the presence of fibrosis (OR 0.258, 95% CI 0.68–0.993; p = 0.049). The complete resection rate was significantly related to the colorectal ESD endoscopist skill level (OR 5.626, 95% CI 1.485–21.313; p = 0.011) and gross lesion type (OR 0.145, 95% CI 0.022–0.936; p = 0.042). When all three technical factors,

Journal

Digestive Diseases and SciencesSpringer Journals

Published: Jun 7, 2018

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