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A new procedure combining local resection with endoscopic submucosal dissection for low rectal tumor: a four-case series
- Source :
- Endoscopy International Open, Vol 08, Iss 02, Pp E214-E220 (2020), Endoscopy International Open
- Publication Year :
- 2020
- Publisher :
- Georg Thieme Verlag KG, 2020.
-
Abstract
- Rectal tumors are traditionally resected by proctectomy to ensure the achievement of negative margins, an approach associated with an adverse impact on subsequent quality of life due to sequelae such as permanent stoma and urinary and sexual dysfunction. Many studies have now demonstrated that recurrence after local excision of early rectal tumors is significantly higher than would typically be expected. We have developed a new procedure, described herein, that combines local resection with endoscopic submucosal dissection for low rectal tumor. We report four consecutive cases (three submucosal tumors and one tumor with clinical deep submucosal invasion) treated at Hiroshima City Asa Citizens Hospital between January 2009 and March 2018. The mean duration of the procedure was 137 minutes. The en bloc resection and histologically complete resection rates were 100 %. Delayed bleeding and perforation rates were 0 %. Postoperative complications were fever and anal pain (one case each). All patients recovered with conservative therapy. No recurrence was found in any of the four patients during a follow-up period of 56 months. Our combined endoscopic and surgical procedure for low rectal tumors enabled definite negative vertical margins, reduced tumor volume, allowed for accurate pathological diagnosis, preserved rectal function, and aided the decision on additional therapy.
- Subjects :
- medicine.medical_specialty
Local resection
business.industry
Urinary system
Perforation (oil well)
Endoscopic submucosal dissection
Surgery
Stoma
03 medical and health sciences
0302 clinical medicine
Sexual dysfunction
Quality of life
030220 oncology & carcinogenesis
medicine
030211 gastroenterology & hepatology
Pharmacology (medical)
lcsh:Diseases of the digestive system. Gastroenterology
medicine.symptom
lcsh:RC799-869
business
Pathological
Innovation forum
Subjects
Details
- Language :
- English
- ISSN :
- 21969736 and 23643722
- Issue :
- 02
- Database :
- OpenAIRE
- Journal :
- Endoscopy International Open
- Accession number :
- edsair.doi.dedup.....2f58aded891e9c2b617ffde4eb6bc444