Retrospektive Analyse der endoskopischen Submukosadissektion (ESD) im Rektum am Ordensklinikum Linz und am Kepler Universitätsklinikum Linz

Endoscopic submucosal dissection (ESD) is a minimally invasive endoscopic procedure for removal of benign and early malignant lesions in the gastrointestinal tract. In this study, we analyze the success and safety of rectal ESD at the Ordensklinikum Linz (Elisabethinen and Barmherzige Schwestern) and the Kepler University Hospital. In addition, we examine whether there is a learning curve related to the success parameters.

This retrospective study includes all 102 rectal ESD procedures performed from 01.12.2010 to 29.02.2020 in the Ordensklinikum Linz or from 01.03.2020 to 21.05.2021 at Kepler University Hospital by a defined endoscopist. Descriptive statistics were generated and regression analyses performed on the collected data.

The en bloc resection rate was 78.4%. The rate of R0 resections was 55.6%. The average procedure time was 179 min. The complication rate was 7.8%. Carcinoma was present in 26.4%, among which the resection was judged to be oncologically adequate in 25.9%. In 61.1% a follow-up examination was evaluated and recurrence was seen in 3.6%. A learning curve was observed with regard to the en bloc resection rate and the procedure time, but not with regard to the rate of R0 resections.

Endoscopic submucosal dissection is a safe method for removal of large rectal adenomas and early carcinomas. The en bloc resection rate of the analyzed interventions is within the range of comparable European studies. The rate of lesions removed from healthy tissue is below the R0 resection rate of the comparative literature, although a learning curve could be observed here.