PMID- 35047343
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220121
IS  - 2364-3722 (Print)
IS  - 2196-9736 (Electronic)
IS  - 2196-9736 (Linking)
VI  - 10
IP  - 1
DP  - 2022 Jan
TI  - Endoscopic submucosal dissection for colorectal neoplasia: outcomes and 
      predictors of recurrence.
PG  - E127-E134
LID - 10.1055/a-1551-3058 [doi]
AB  - Background and study aims  The role of endoscopic submucosal dissection (ESD) for 
      colorectal lesions in Western communities is unclear and its adoption is still 
      limited. The aim of this study is to assess the long-term outcomes of a large 
      cohort of patients treated with colorectal ESD in a tertiary Western center. 
      Patients and methods  A retrospective analysis was conducted on patients treated 
      by ESD for superficial colorectal lesions between February 2011 and November 
      2019. The primary outcome was the recurrence rate. Secondary outcomes were 
      en-bloc and R0 resection rates, procedural time, adverse events (AEs), and need 
      for surgery. The curative resection rate was assessed for submucosal invasive 
      lesions. Results  A total of 327 consecutive patients, median age 69 years (IQR 
      60-76); 201 men (61.5 %) were included in the analysis. Of the lesions, 90.8 % 
      were resected in an en-bloc fashion. The rate of R0 resection was 83.1 % 
      (217/261) and 44.0 % (29/66) for standard and hybrid ESD techniques, 
      respectively. Submucosal invasion and piecemeal resection independently predicted 
      R1 resections. A total of 18(5.5 %) intra-procedural AEs (perforation:11, 
      bleeding:7) and 12(3.7 %) post-procedural AEs occurred (perforation:2, bleeding: 
      10). Eighteen adenoma recurrences per 1,000 person-years (15cases, 5.6 %) were 
      detected after a median follow-up time of 36 months. All recurrences were 
      detected within 12 months. No carcinoma recurrences were observed. R1 resection 
      status and intra-procedural AEs independently predicted recurrences with seven vs 
      150 recurrences per 1,000 person-years in the R0 vs R1 group, respectively. 
      Conclusions  Colorectal ESD is a safe and effective option for managing 
      superficial colorectal neoplasia in a Western setting, with short and long-terms 
      outcomes comparable to Eastern studies. En-bloc R0 resection and absence of 
      intra-procedural AEs are associated with reduced risk of recurrence.
CI  - The Author(s). This is an open access article published by Thieme under the terms 
      of the Creative Commons Attribution-NonDerivative-NonCommercial License, 
      permitting copying and reproduction so long as the original work is given 
      appropriate credit. Contents may not be used for commercial purposes, or adapted, 
      remixed, transformed or built upon. 
      (https://creativecommons.org/licenses/by-nc-nd/4.0/).
FAU - Maselli, Roberta
AU  - Maselli R
AD  - Humanitas University, Department of Biomedical Science, Pieve Emanuele (Milan), 
      Italy.
AD  - Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Research 
      Hospital, Humanitas University, Rozzano (Milan), Italy.
FAU - Spadaccini, Marco
AU  - Spadaccini M
AD  - Humanitas University, Department of Biomedical Science, Pieve Emanuele (Milan), 
      Italy.
AD  - Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Research 
      Hospital, Humanitas University, Rozzano (Milan), Italy.
FAU - Belletrutti, Paul J
AU  - Belletrutti PJ
AD  - Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Research 
      Hospital, Humanitas University, Rozzano (Milan), Italy.
FAU - Galtieri, Piera Alessia
AU  - Galtieri PA
AD  - Humanitas University, Department of Biomedical Science, Pieve Emanuele (Milan), 
      Italy.
FAU - Attardo, Simona
AU  - Attardo S
AD  - Gastroenterology Unit, Ospedale Maggiore della Carita, Novara, Italy.
FAU - Carrara, Silvia
AU  - Carrara S
AD  - Humanitas University, Department of Biomedical Science, Pieve Emanuele (Milan), 
      Italy.
FAU - Anderloni, Andrea
AU  - Anderloni A
AD  - Humanitas University, Department of Biomedical Science, Pieve Emanuele (Milan), 
      Italy.
FAU - Fugazza, Alessandro
AU  - Fugazza A
AD  - Humanitas University, Department of Biomedical Science, Pieve Emanuele (Milan), 
      Italy.
FAU - Ferrara, Elisa Chiara
AU  - Ferrara EC
AD  - Humanitas University, Department of Biomedical Science, Pieve Emanuele (Milan), 
      Italy.
FAU - Pellegatta, Gaia
AU  - Pellegatta G
AD  - Humanitas University, Department of Biomedical Science, Pieve Emanuele (Milan), 
      Italy.
FAU - Iannone, Andrea
AU  - Iannone A
AD  - Section of Gastroenterology, Department of Emergency and Organ Transplantation, 
      University of Bari, Bari, Italy.
FAU - Hassan, Cesare
AU  - Hassan C
AD  - Digestive Endoscopy Unit, Nuovo Regina Margherita Hospital, Rome, Italy.
FAU - Repici, Alessandro
AU  - Repici A
AD  - Humanitas University, Department of Biomedical Science, Pieve Emanuele (Milan), 
      Italy.
AD  - Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Research 
      Hospital, Humanitas University, Rozzano (Milan), Italy.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20220114
PL  - Germany
TA  - Endosc Int Open
JT  - Endoscopy international open
JID - 101639919
PMC - PMC8759944
COIS- Competing interests The authors declare that they have no conflict of interest.
EDAT- 2022/01/21 06:00
MHDA- 2022/01/21 06:01
PMCR- 2022/01/01
CRDT- 2022/01/20 06:05
PHST- 2021/01/23 00:00 [received]
PHST- 2021/07/09 00:00 [accepted]
PHST- 2022/01/20 06:05 [entrez]
PHST- 2022/01/21 06:00 [pubmed]
PHST- 2022/01/21 06:01 [medline]
PHST- 2022/01/01 00:00 [pmc-release]
AID - 10.1055/a-1551-3058 [doi]
PST - epublish
SO  - Endosc Int Open. 2022 Jan 14;10(1):E127-E134. doi: 10.1055/a-1551-3058. 
      eCollection 2022 Jan.