ArticleDEN open2024
Diagnostic and therapeutic strategies for colorectal tumor with positive muscle-retracting sign.
Article in DEN open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Endoscopic submucosal dissection for a colorectal tumor with coexisting muscle-retracting sign and underlying diverticulum: the first reported case.Oxford medical case reports · 2026Article
- Dissection of giant bulky colorectal lesions with muscle retracting sign (MRS+). Strategic management of gravitational traction during ESD might be the solution.Techniques in coloproctology · 2025Article
- Outcome and predictive factors for perforation in orthodontic rubber band-assisted endoscopic submucosal dissection of fibrotic colorectal lesions.Scientific reports · 2024Article
- Outcomes in colorectal endoscopic submucosal dissection for large protruded lesions: A retrospective multicenter study.Endoscopy international open · 2024Article
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objectives: Endoscopic submucosal dissection (ESD) for colorectal tumors with positive muscle-retracting (MR) sign often results in incomplete resection or discontinuation owing to the difficulty of submucosal dissection. The present study aimed to evaluate the usefulness of endoscopic ultrasonography (EUS) in diagnosing the MR sign and performing ESD using the pocket-creation method (PCM). Methods: Thirty-six cases of colorectal tumors with positive MR sign during ESD between January 2015 and December 2021 were retrospectively reviewed. Cases were divided into two groups: 1) the conventional method (CM) group, comprising 29 cases, and 2) the PCM group with seven cases, in which preoperative EUS and ESD using PCM were performed. Treatment outcomes were compared between the groups. The diagnostic yield of EUS for the MR sign was evaluated among large sessile tumors >20 mm in which preoperative EUS was performed. Results: Histologic diagnosis was adenoma or Tis carcinoma in 12 cases (33%), T1 carcinoma in 18 cases (50%), T2 carcinoma in four cases (11%), and unevaluable in two cases (6%). The sensitivity and specificity of the EUS-MR sign for large sessile tumors were 87.5% and 83.3%, respectively. ESD was achieved in all cases in the PCM group, although it was discontinued in eight cases (28%) in the CM group. There were significant differences between the PCM and CM groups in en bloc resection (100% vs. 48%, Conclusion: The MR sign can be predicted by preoperative EUS, and ESD using PCM allows en bloc resection.
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