Outcomes of endoscopic sub-mucosal dissection in laterally spreading colorectal polyps: A tertiary care centre experience from India

期刊论文
发表日期：

2024年8月1日

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Zaheer Nabi,
Manchu Chaithanya,
Pradev Inavolu,
Mohan Ramchandani,
Palle Manohar Reddy,
Mahiboob Sayyed,
Jahangeer Basha,
Partha Pal,
Anuradha Sekharan,
Rajesh Goud,
Praveen Reddy,
Nitin Jagtap,
Rama Kotla,
Rakesh Kalpala,
Santhosh Darisetty,
Sundeep Lakhtakia,
Guduru Venkat Rao,
Manu Tandan,
Rajesh Gupta,
Rangarao Devarasetti,
Pradeep Rebala,
Mahesh Shetty,
D. Nageshwar Reddy

摘要

Background

Endoscopic sub-mucosal dissection (ESD) is an established endoscopic modality for the management of colorectal polyps. However, there are no studies regarding the outcomes of ESD from India. In this study, we aimed at evaluating the outcomes of ESD in patients with adenomatous polyps in the colon and rectum.

Methods

Data of consecutive patients who underwent ESD for colorectal polyps from 2018 to 2021 were analyzed, retrospectively. The primary outcome of the study was the technical success of ESD. The secondary outcomes included the rate of histologically complete resection (R0), adverse events and recurrence.

Results

Seventy patients (63.5 years, 60% males) underwent ESD for polyps in colon and rectum. A majority were located in rectum (80%) and sigmoid colon (15.7%). Narrow band classification of the polyps was Japanese Narrow Band Imaging Expert Team (JNET)-2a in 50 (71.4%) and JNET-2b in 13 (18.6%) patients. ESD was technically successful in 64 (91.4%) patients using conventional technique (72.8%) and pocket or tunnelling technique (18.6%). There were no major adverse events. Histologically RO was achieved in 58 (82.8%) patients and deep sub-mucosal invasion was noted in 12 patients. At a median follow-up of 19 (interquartile range [IQR] 15–27) months, recurrence was noticed in four (5.7%) patients all of which could be managed endoscopically.

Conclusion

ESD, performed at a tertiary care centre in India, yields high rates of technical success and histologically R0, with a relatively low incidence of adverse events and recurrences.

Graphical Abstract