Hybrid endoscopic submucosal dissection: An alternative resection modality for large laterally spreading tumors in the cecum?
Hybrid endoscopic submucosal dissection: An alternative resection modality for large laterally spreading tumors in the cecum?
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DOI：
10.1186/s12876-021-01766-w
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发表时间：
2021-05-05
影响因子：
2.4
通讯作者：
Linghu EQ
中科院分区：
文献类型：
--
作者：
Wang XY;Chai NL;Zhai YQ;Li LS;Wang ZT;Zou JL;Shi YS;Linghu EQ
内窥镜下切除盲肠大的、侧向扩散的肿瘤(LSTs)是具有挑战性的。在这里，我们报告了混合式内窥镜下黏膜下剥离术(ESD)治疗大型盲肠LST的临床结果。我们回顾了2008年1月至2019年6月期间接受 ≥ 或混合性ESD手术的盲肠LSTS患者的数据。我们比较了基线特征和临床结果，包括手术时间、全切除和完全切除率以及不良事件。共有62名患者参加了这项研究。ESD组27例，混合型ESD组35例。混合型ESD更多地用于黏膜下纤维化的病变。两组患者的特征没有发现其他显著差异。混合型ESD组手术时间(27.60 ± 17.21min)明显短于ESD组(52.63 ± 44.202 min，P = 0.001)。混合手术组的肿瘤全切率(77.1%vs.81.5%，P = 0.677)和完全切除率(71.4%vs.81.5%，P = 0.359)均低于单纯手术组(P<0.05)，但差异无统计学意义。两组穿孔和术后出血率(2.9%vs.3.7%，P = 0.684)相似。一名患者在ESD手术过程中穿孔，并进行了手术治疗。混合型ESD组有1例出现术后出血，经内窥镜止血成功治疗。ESD组有6名患者出现术后发热和腹痛，混合型ESD组有5名患者出现术后发热和腹痛。ESD组中有1例复发，经内窥镜切除。这项研究的结果表明，混合式ESD可能是治疗伴有粘膜下纤维化的盲肠大LST的一种替代切除策略。
Endoscopic resection for large, laterally spreading tumors (LSTs) in the cecum is challenging. Here we report on the clinical outcomes of hybrid endoscopic submucosal dissection (ESD) in large cecal LSTs. We retrospectively reviewed data from patients with cecal LSTs ≥ 2 cm who underwent ESD or hybrid ESD procedures between January of 2008 and June of 2019. We compared the baseline characteristics and clinical outcomes, including procedure time, the en bloc and complete resection rates, and adverse events. A total of 62 patients were enrolled in the study. There were 27 patients in the ESD group and 35 patients in the hybrid ESD group, respectively. Hybrid ESD was more used for lesions with submucosal fibrosis. No other significant differences were found in patient characteristics between the two groups. The hybrid ESD group had a significantly shorter procedure time compared with the ESD group (27.60 ± 17.21 vs. 52.63 ± 44.202 min, P = 0.001). The en bloc resection rate (77.1% vs. 81.5%, P = 0.677) and complete resection rate (71.4% vs. 81.5%, P = 0.359) of hybrid ESD were relatively lower than that of the ESD group in despite of no significant difference was found. The perforation and post-procedure bleeding rate (2.9% vs. 3.7%, P = 0.684) were similar between the two groups. One patient perforated during the ESD procedure, which was surgically treated. One patient in the hybrid ESD group experienced post-procedure bleeding, which was successfully treated with endoscopic hemostasis. Post-procedural fever and abdominal pain occurred in six patients in the ESD group and five patients in the hybrid ESD group. One patient in the ESD group experienced recurrence, which was endoscopically resected. The results of this study indicate that hybrid ESD may be an alternative resection strategy for large cecal LSTs with submucosal fibrosis.
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影响因子：
29.4
作者：
Burgess, Nicholas G.;Hourigan, Luke F.;Bourke, Michael J.
通讯作者：
Bourke, Michael J.
影响因子：
7.7
作者：
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通讯作者：
Byeon, Jeong-Sik
影响因子：
29.4
作者：
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通讯作者：
Byth, Karen
DOI：
10.1111/j.1440-1746.2011.06977.x
发表时间：
2012-04-01
影响因子：
4.1
作者：
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通讯作者：
Chayama, Kazuaki
影响因子：
9.8
作者：
Buddingh, K. Tim;Herngreen, Thomas;ter Borg, Frank
通讯作者：
ter Borg, Frank