Limits...
Re-evaluation of indications and outcomes of endoscopic excision procedures for colorectal tumors: a review.

Cai S, Zhong Y, Zhou P, Xu J, Yao L - Gastroenterol Rep (Oxf) (2013)

Bottom Line: For the excision of colorectal tumors, each of these techniques has been characterized as having a high total resection rate, low recurrence rate or low complication rate.On the other hand, to excise a tumor larger than 20 mm in diameter, ESD and ESD-S should be the first choices.However, if the patient has a high risk of complications due to ESD or ESD-S, the use of EMR-P would be suitable.

View Article: PubMed Central - PubMed

Affiliation: Endoscopic Center, Zhongshan Hospital of Fudan University, Shanghai, China and Department of General Surgery, Zhongshan Hospital of Fudan University, Shanghai, China.

ABSTRACT
Endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR) are useful therapeutic techniques for colorectal tumors. Currently, new techniques based on these procedures are available, such as endoscopic submucosal dissection with snare (ESD-S) and endoscopic mucosal resection with pre-cutting (EMR-P). For the excision of colorectal tumors, each of these techniques has been characterized as having a high total resection rate, low recurrence rate or low complication rate. In this study, we analysed clinical trials that had recently been published, to search for the most appropriate endoscopic treatment for colorectal tumors. Our search results revealed the following: for a tumor with a diameter less than 20 mm, the surgeon should choose ESD, ESD-S, EMR-P or EMR, depending on the condition of the tumor. On the other hand, to excise a tumor larger than 20 mm in diameter, ESD and ESD-S should be the first choices. However, if the patient has a high risk of complications due to ESD or ESD-S, the use of EMR-P would be suitable. Because of the high possibility of canceration in a tumor larger than 20 mm in diameter, EMR is not the optimal endoscopic treatment for the excision of a colorectal tumor, due to a low total resection rate and a high recurrence rate.

No MeSH data available.


Related in: MedlinePlus

The process of endoscopic submucosal dissection with snare (ESD-S). (A) The lesion before resection. (B) Inject saline solution at the submucosal at the lateral of the marked multi-points. (C) Cut the edge of lesion. (D) Use snare to resect lesion. (E) The wound after resection. (F) The lesion.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3921000&req=5

got034-F3: The process of endoscopic submucosal dissection with snare (ESD-S). (A) The lesion before resection. (B) Inject saline solution at the submucosal at the lateral of the marked multi-points. (C) Cut the edge of lesion. (D) Use snare to resect lesion. (E) The wound after resection. (F) The lesion.

Mentions: The procedure for ESD-S is approximately the same as that for ESD (Figure 3). The difference with the ESD-S technique is that the operator switches to using a snare to completely separate the remaining tissue directly after the lesions have been reduced to a quarter or even smaller proportion of their total size, instead of using an IT or Hook knife to resect them.Figure 3.


Re-evaluation of indications and outcomes of endoscopic excision procedures for colorectal tumors: a review.

Cai S, Zhong Y, Zhou P, Xu J, Yao L - Gastroenterol Rep (Oxf) (2013)

The process of endoscopic submucosal dissection with snare (ESD-S). (A) The lesion before resection. (B) Inject saline solution at the submucosal at the lateral of the marked multi-points. (C) Cut the edge of lesion. (D) Use snare to resect lesion. (E) The wound after resection. (F) The lesion.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3921000&req=5

got034-F3: The process of endoscopic submucosal dissection with snare (ESD-S). (A) The lesion before resection. (B) Inject saline solution at the submucosal at the lateral of the marked multi-points. (C) Cut the edge of lesion. (D) Use snare to resect lesion. (E) The wound after resection. (F) The lesion.
Mentions: The procedure for ESD-S is approximately the same as that for ESD (Figure 3). The difference with the ESD-S technique is that the operator switches to using a snare to completely separate the remaining tissue directly after the lesions have been reduced to a quarter or even smaller proportion of their total size, instead of using an IT or Hook knife to resect them.Figure 3.

Bottom Line: For the excision of colorectal tumors, each of these techniques has been characterized as having a high total resection rate, low recurrence rate or low complication rate.On the other hand, to excise a tumor larger than 20 mm in diameter, ESD and ESD-S should be the first choices.However, if the patient has a high risk of complications due to ESD or ESD-S, the use of EMR-P would be suitable.

View Article: PubMed Central - PubMed

Affiliation: Endoscopic Center, Zhongshan Hospital of Fudan University, Shanghai, China and Department of General Surgery, Zhongshan Hospital of Fudan University, Shanghai, China.

ABSTRACT
Endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR) are useful therapeutic techniques for colorectal tumors. Currently, new techniques based on these procedures are available, such as endoscopic submucosal dissection with snare (ESD-S) and endoscopic mucosal resection with pre-cutting (EMR-P). For the excision of colorectal tumors, each of these techniques has been characterized as having a high total resection rate, low recurrence rate or low complication rate. In this study, we analysed clinical trials that had recently been published, to search for the most appropriate endoscopic treatment for colorectal tumors. Our search results revealed the following: for a tumor with a diameter less than 20 mm, the surgeon should choose ESD, ESD-S, EMR-P or EMR, depending on the condition of the tumor. On the other hand, to excise a tumor larger than 20 mm in diameter, ESD and ESD-S should be the first choices. However, if the patient has a high risk of complications due to ESD or ESD-S, the use of EMR-P would be suitable. Because of the high possibility of canceration in a tumor larger than 20 mm in diameter, EMR is not the optimal endoscopic treatment for the excision of a colorectal tumor, due to a low total resection rate and a high recurrence rate.

No MeSH data available.


Related in: MedlinePlus