Evidence map›Paper›PMID 39102130›Full record

ArticleIndian journal of gastroenterology : official journal of the Indian Society of Gastroenterology2024

Clinical audit of endoscopic sub-mucosal dissection performed for complex lateral spreading colorectal tumors from a region non-endemic for colorectal cancer.

Jaseem Ansari, Harsh Bapaye, Jimil Shah, Hameed Raina, Ashish Gandhi, Jay Bapaye, Ajay B R, Arun Arora Pagadapelli, Amol Bapaye

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Article in Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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0cells of the map it votes in
2citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Jaseem AnsariShivanand Desai Center for Digestive Disorders, Deenanath Mangeshkar Hospital and Research Center, Erandwane, Pune, 411 004, India.
Harsh BapayeDepartment of Internal Medicine, Byramjee Jeejeebhoy Medical College, Pune, 411 001, India.
Jimil ShahDepartment of Gastroenterology, Post Graduate Institute of Medical Research, Chandigarh, 160 012, India.
Hameed RainaShivanand Desai Center for Digestive Disorders, Deenanath Mangeshkar Hospital and Research Center, Erandwane, Pune, 411 004, India.
Ashish GandhiShivanand Desai Center for Digestive Disorders, Deenanath Mangeshkar Hospital and Research Center, Erandwane, Pune, 411 004, India.
Jay BapayeDepartment of Gastroenterology and Hepatology, Virginia Tech Carillon School of Medicine, Roanoke, VA, USA.
Ajay B RShivanand Desai Center for Digestive Disorders, Deenanath Mangeshkar Hospital and Research Center, Erandwane, Pune, 411 004, India.
Arun Arora PagadapelliShivanand Desai Center for Digestive Disorders, Deenanath Mangeshkar Hospital and Research Center, Erandwane, Pune, 411 004, India.
Amol BapayeShivanand Desai Center for Digestive Disorders, Deenanath Mangeshkar Hospital and Research Center, Erandwane, Pune, 411 004, India. amolbapaye@gmail.com.ORCID 0000-0001-7632-814X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEndoscopic resection is currently the treatment of choice for laterally spreading tumors (LSTs). Endoscopic sub-mucosal dissection (ESD) can achieve higher enbloc resection and R0 resection, albeit at a slightly higher risk of complications. Given scarce data on ESD from India, we performed a retrospective analysis of our experience with colorectal ESD (CR-ESD) to know its clinical efficacy and complications as well as to assess the learning curve of CR-ESD in non-endemic-areas.

methodsRetrospective analysis of prospectively maintained datasheet performed. All patients with large (>2cm), complex or recurrent colorectal LST who underwent ESD at our center between 2012 and 2021 were included in the study. Various baseline lesion-related parameters, procedure-related parameters, enbloc resection (ER) rates, R0 margins and adverse event rates were retrieved. CUSUM analysis was performed to calculate the minimum required procedures to achieve competency in CR-ESD.

resultsTotal 149 patients were included in the study; mean patient age was 61.36±18.21 years. Most patients had lesions in rectum (n=102; 68.5%) followed by sigmoid colon (n=25; 16.8%). The mean lesion size was 46.62 ± 25.46 mm and the mean procedure duration for ESD was 219.30 ± 150.05 min. ER was achieved in 94.6% of lesions. R0 resection was achieved in 132 patients (88.6%). Overall, six (4%) adverse events were noted, of which one required surgical intervention. As many as 105 patients (70.5%) had adenomatous lesions on histology. Seventy-four patients underwent follow-up colonoscopy, of which three had a recurrence of adenomatous lesions and five had post-resection stricture requiring endoscopic dilation. CUSUM curve analysis calculated the learning curve for ESD was 47 resections for ER and 55 for the occurrence of AEs, with a composite CUSUM at 47 procedures.

conclusionCR-ESD even in non-endemic area is associated with high en bloc resection rates, R0 resection rates and acceptable complication profile. Approximately 50 cases of CR-ESD are required to achieve competency.

Indexed as

Colorectal NeoplasmsEndoscopic Mucosal ResectionLearning CurveAdultAgedClinical AuditColonoscopyFemaleHumansIndiaIntestinal MucosaMaleMiddle AgedRetrospective StudiesTreatment OutcomeColorectal adenocarcinomaColorectal adenomaColorectal polypEMREndoscopic mucosal resectionEndoscopic sub-mucosal dissectionESDFlat polypLateral spreading tumorLSTNBIPolypSessile polyp

Identifiers

PMID39102130

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.