کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
5659429 1407463 2017 12 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Management and risk factor of stenosis after endoscopic submucosal dissection for colorectal neoplasms
ترجمه فارسی عنوان
مدیریت و عامل خطر تنگی پس از انسداد تخریب انسداد تخریب نئوپلاسم های کولورکتال
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی بیماری‌های گوارشی
چکیده انگلیسی

Background and AimAlthough endoscopic submucosal dissection (ESD) enables en bloc removal of large colorectal neoplasms, the incidence of stenosis after ESD and its risk factors have not been well described. This study aimed to determine the risk factors of stenosis and verify the surveillance and treatment of stenosis.MethodsThis retrospective study included 822 patients, with a total of 912 consecutive colorectal lesions, who underwent ESD from September 2003 to May 2015. The main outcome measures were incidence of stenosis and its relationship with the clinicopathologic factors in surveillance.ResultsSurveillance endoscopy was performed 6 months after ESD. Four of the 822 patients (0.49%) developed stenosis and required unanticipated endoscopy. The other 908 cases in 818 patients showed no symptoms or only slight abdominal discomfort (that was controlled with medication) and did not require any dilation or steroid therapies. Post-ESD stenosis was observed in 11.1% (2/18) of patients with circumferential resection between ≥90% and <100% and in 50% (2/4) of patients with circumferential resection of 100%. Among the 50 cases with a circumferential mucosal defect ≥75%, a circumferential mucosal defect ≥90% was a significant risk factor (P = .005). Four patients with stenosis were treated successfully by endoscopic dilation.ConclusionsCircumferential mucosal defect of more than 90% is a significant risk factor for stenosis after colorectal ESD. Surveillance endoscopy 6 months after ESD is recommended to assess for development of stenosis. Defects smaller than 90% do not require close endoscopic follow-up or prophylactic measures for prevention of post-ESD stenosis. (UMIN clinical trial registration number: UMIN000015754.)

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Gastrointestinal Endoscopy - Volume 86, Issue 2, August 2017, Pages 358-369
نویسندگان
, , , , , , , , , , , , , , , , , , , , , , , ,