医学
淋巴血管侵犯
内镜黏膜下剥离术
结直肠癌
解剖(医学)
外科
回顾性队列研究
瘤芽
粘膜切除术
转移
放射科
内窥镜检查
癌症
淋巴结转移
内科学
作者
Adrien Patenotte,Clara Yzet,Timothée Wallenhorst,Fabien Subtil,Sarah Leblanc,Marion Schaefer,Thomas Walter,Thomas Lambin,Tanguy Fenouil,Pierre Lafeuille,Jean–Baptiste Chevaux,Romain Legros,Florian Rostain,Jérôme Rivory,Jérémie Jacques,Vincent Lépilliez,Mathieu Pioche
出处
期刊:Endoscopy
[Georg Thieme Verlag KG]
日期:2022-06-01
卷期号:55 (02): 192-197
被引量:5
摘要
Endoscopic submucosal dissection (ESD) is potentially a curative treatment for T1 colorectal cancer under certain conditions. The aim of this study was to evaluate the feasibility and effectiveness of ESD for lesions with a suspicion of focal deep invasion.In this retrospective multicenter study, consecutive patients with colorectal neoplasia displaying a focal (< 15 mm) deep invasive pattern (FDIP) that were treated by ESD were included. We excluded ulcerated lesions (Paris III), lesions with distant metastasis, and clearly advanced tumors (tumoral strictures).124 patients benefited from 126 diagnostic dissection attempts for FDIP lesions. Dissection was feasible in 120/126 attempts (95.2 %) and, where possible, the en bloc and R0 resection rates were 95.8 % (115/120) and 76.7 % (92/120), respectively. Thirty-three resections (26.2 %) were for very low risk tumors, so considered curative, and 38 (30.2 %) were for low risk lesions. Noncurative R0 resections were for lesions with lymphatic or vascular invasion (LVI; n = 8), or significant budding (n = 9), and LVI + budding combination (n = 4).ESD is feasible and safe for colorectal lesions with an FDIP ≤ 15 mm. It was curative in 26.6 % of patients and could be a valid option for a further 30.6 % of patients with low risk T1 cancers, especially for frail patients with co-morbidities.
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