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Endoscopic submucosal dissection for premalignant lesions and noninvasive early gastrointestinal cancers.
World J Gastroenterol 2011; 17(13):1701-9WJ

Abstract

AIM

To investigate the indication, feasibility, safety, and clinical utility of endoscopic submucosal dissection (ESD) in the management of various gastrointestinal pathologies.

METHODS

The medical records of 60 consecutive patients (34 female, 26 male) who underwent ESD at the gastroenterology department of Kocaeli University from 2006-2010 were examined. Patients selected for ESD had premalignant lesions or non-invasive early cancers of the gastrointestinal tract and had endoscopic and histological diagnoses. Early cancers were considered to be confined to the submucosa, with no lymph node involvement by means of computed tomography and endosonography.

RESULTS

Sixty ESD procedures were performed. The indications were epithelial lesions (n = 39) (33/39 adenoma with high grade dysplasia, 6/39 adenoma with low grade dysplasia), neuroendocrine tumor (n = 7), cancer (n = 7) (5/7 early colorectal cancer, 2/7 early gastric cancer), granular cell tumor (n = 3), gastrointestinal stromal tumor (n = 2), and leiomyoma (n = 2). En bloc and piecemeal resection rates were 91.6% (55/60) and 8.3% (5/60), respectively. Complete and incomplete resection rates were 96.6% (58/60) and 3.3% (2/60), respectively. Complications were major bleeding [n = 3 (5%)] and perforations [n = 5 (8.3%)] (4 colon, 1 stomach). Two patients with colonic perforations and two patients with submucosal lymphatic and microvasculature invasion (1 gastric carcinoid tumor, 1 colonic adenocarcinoma) were referred to surgery. During a mean follow-up of 12 mo, 1 patient with adenoma with high grade dysplasia underwent a second ESD procedure to resect a local recurrence.

CONCLUSION

ESD is a feasible and safe method for treatment of premalignant lesions and early malignant gastrointestinal epithelial and subepithelial lesions. Successful en bloc and complete resection of lesions yield high cure rates with low recurrence.

Authors+Show Affiliations

Division of Gastroenterology, Kocaeli University Medical School, Kocaeli 41000, Turkey. shulagu@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21483630

Citation

Hulagu, Sadettin, et al. "Endoscopic Submucosal Dissection for Premalignant Lesions and Noninvasive Early Gastrointestinal Cancers." World Journal of Gastroenterology, vol. 17, no. 13, 2011, pp. 1701-9.
Hulagu S, Senturk O, Aygun C, et al. Endoscopic submucosal dissection for premalignant lesions and noninvasive early gastrointestinal cancers. World J Gastroenterol. 2011;17(13):1701-9.
Hulagu, S., Senturk, O., Aygun, C., Kocaman, O., Celebi, A., Konduk, T., ... Kalayci, C. (2011). Endoscopic submucosal dissection for premalignant lesions and noninvasive early gastrointestinal cancers. World Journal of Gastroenterology, 17(13), pp. 1701-9. doi:10.3748/wjg.v17.i13.1701.
Hulagu S, et al. Endoscopic Submucosal Dissection for Premalignant Lesions and Noninvasive Early Gastrointestinal Cancers. World J Gastroenterol. 2011 Apr 7;17(13):1701-9. PubMed PMID: 21483630.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Endoscopic submucosal dissection for premalignant lesions and noninvasive early gastrointestinal cancers. AU - Hulagu,Sadettin, AU - Senturk,Omer, AU - Aygun,Cem, AU - Kocaman,Orhan, AU - Celebi,Altay, AU - Konduk,Tolga, AU - Koc,Deniz, AU - Sirin,Goktug, AU - Korkmaz,Ugur, AU - Duman,Ali Erkan, AU - Bozkurt,Neslihan, AU - Dindar,Gokhan, AU - Attila,Tan, AU - Gurbuz,Yesim, AU - Tarcin,Orhan, AU - Kalayci,Cem, PY - 2010/10/21/received PY - 2010/11/20/revised PY - 2010/11/27/accepted PY - 2011/4/13/entrez PY - 2011/4/13/pubmed PY - 2011/7/21/medline KW - Endoscopic submucosal dissection KW - Gastrointestinal stromal tumor KW - Neuroendocrine tumor KW - Noninvasive early gastrointestinal cancer KW - Premalignant gastrointestinal lesion SP - 1701 EP - 9 JF - World journal of gastroenterology JO - World J. Gastroenterol. VL - 17 IS - 13 N2 - AIM: To investigate the indication, feasibility, safety, and clinical utility of endoscopic submucosal dissection (ESD) in the management of various gastrointestinal pathologies. METHODS: The medical records of 60 consecutive patients (34 female, 26 male) who underwent ESD at the gastroenterology department of Kocaeli University from 2006-2010 were examined. Patients selected for ESD had premalignant lesions or non-invasive early cancers of the gastrointestinal tract and had endoscopic and histological diagnoses. Early cancers were considered to be confined to the submucosa, with no lymph node involvement by means of computed tomography and endosonography. RESULTS: Sixty ESD procedures were performed. The indications were epithelial lesions (n = 39) (33/39 adenoma with high grade dysplasia, 6/39 adenoma with low grade dysplasia), neuroendocrine tumor (n = 7), cancer (n = 7) (5/7 early colorectal cancer, 2/7 early gastric cancer), granular cell tumor (n = 3), gastrointestinal stromal tumor (n = 2), and leiomyoma (n = 2). En bloc and piecemeal resection rates were 91.6% (55/60) and 8.3% (5/60), respectively. Complete and incomplete resection rates were 96.6% (58/60) and 3.3% (2/60), respectively. Complications were major bleeding [n = 3 (5%)] and perforations [n = 5 (8.3%)] (4 colon, 1 stomach). Two patients with colonic perforations and two patients with submucosal lymphatic and microvasculature invasion (1 gastric carcinoid tumor, 1 colonic adenocarcinoma) were referred to surgery. During a mean follow-up of 12 mo, 1 patient with adenoma with high grade dysplasia underwent a second ESD procedure to resect a local recurrence. CONCLUSION: ESD is a feasible and safe method for treatment of premalignant lesions and early malignant gastrointestinal epithelial and subepithelial lesions. Successful en bloc and complete resection of lesions yield high cure rates with low recurrence. SN - 2219-2840 UR - https://www.unboundmedicine.com/medline/citation/21483630/Endoscopic_submucosal_dissection_for_premalignant_lesions_and_noninvasive_early_gastrointestinal_cancers_ L2 - http://www.wjgnet.com/1007-9327/full/v17/i13/1701.htm DB - PRIME DP - Unbound Medicine ER -