International Session(Workshop)3(JGES・JSGE・JSGS・JSGCS)
Sat. November 4th   14:00 - 16:30   Room 11: Portopia Hotel South Wing Topaz
Results of ESD for cecal neoplasms including appendiceal orifice
Takeshi Yamamura1, Masanao Nakamura2, Hiroki Kawashima1
1Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, 2Department of Endoscopy, Nagoya University Hospital
[Background] ESD procedure for colorectal neoplasms close to the appendiceal orifice is considered as difficult. Therefore, we retrospectively reviewed the results and safety of ESD for the cecal lesions including the appendiceal orifice.
[Subjects and Methods] 141 cecal lesions were included and classified into two groups: lesions extended into the appendiceal orifice (Group A) and lesions away from the appendiceal orifice (Group C). Patient information, endoscopic and pathological results, and posttreatment course were compared between the two groups.
[Results] There were 30 lesions in Group A and 111 lesions in Group C. There were no differences in tumor size, procedure time, and the results of ESD including en-bloc resection and complete resection rate as well. But intraoperative perforation rates were significantly higher in group A. Concerning postoperative complications, there was no difference in the incidence of post-electrocoagulation syndrome. Furthermore, 15 patients with intra-appendiceal extension lesions were extracted. When considering the history of appendectomy, the rate of en-bloc resection was 100% with appendectomy and 66.7% without appendectomy. All lesions of failed en-bloc resections were the entire circumferential lesions around the appendiceal orifice without the use of traction devices.
[Conclusion] ESD treatment of cecal neoplasm close to the appendiceal orifice can be performed, even in intra-appendiceal extension lesions. However, we must be careful about the high perforation rate.
Index Term 1: colorectal ESD
Index Term 2: appendiceal orifice
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