First experience of one and two-step endoscopic submucosal dissection of colorectal neoplasms
- Authors: Sayfutdinov IM1, Slavin LE1,2, Khayrullin RN1, Mukharyamov MS1,3, Zimagulov RT1, Ivanov AI2,4, Panasyuk MV1, Sayfutdinova DI3, Ivanov IA5
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Affiliations:
- Interregional Clinical-Diagnostic Center
- Kazan State Medical Academy
- Kazan State Medical University
- Tatarstan Cancer Center
- Kazan (Volga region) Federal University
- Issue: Vol 101, No 3 (2020)
- Pages: 446-451
- Section: Clinical experiences
- URL: https://journals.rcsi.science/kazanmedj/article/view/19443
- DOI: https://doi.org/10.17816/KMJ2020-446
- ID: 19443
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Abstract
Aim. To analyze the results of one and two-step endoscopic submucosal dissection in the treatment of colorectal neoplasms.
Methods. Between 2018 and 2019, 17 patients (6 men and 11 women) aged 33 to 79 years underwent 21 endoscopic submucosal dissections of colorectal neoplasms ranging in size from 1.0 to 6.0 cm. Submucosal fibrosis was identified in 2 (11.8%) patients, epithelial neoplasms in 15 (88.2%) patients including laterally spreading tumors in 9 (60%), and large sessile colorectal polyps in 6 (40%) patients. Histological examination revealed a carcinoid tumor (11.8%), adenoma with low-grade (64.7%) and high-grade (23.5%) intraepithelial neoplasia. 13 patients were subjected to the one-step operation, and 4 patients required the two-step operation with a 1-day interval. Follow-up examinations after the operation were performed, on average, between 2 and 6 months.
Results. En bloc endoscopic submucosal dissection was performed in 11 (64.7%) patients, 4 of them in combination with mucosal resection. Endoscopic piecemeal resection of the neoplasia was performed in 6 (35.3%) patients. The average operative time was 155±73 minutes (range 40–320 min). Intraoperative complications, which were eliminated endoscopically, occurred during 8 (38.1%) of 21 operations: intensive bleeding in 6 (75%) patients, diastasis of muscle fibers in 1 (12.5%) patient, perforation of the intestinal wall in 1 (12.5%) patient. At the follow-up at 6 months, all patients formed the scar at the surgical area, while 3 patients required endoscopic removal of residual adenoma 2 months after the operation.
Conclusion. Endoscopic submucosal dissection is an effective method for removing colorectal neoplasms, while two-step dissection is a promising approach to the development of the technique.Keywords: one and two-step dissection, endoscopic submucosal dissection (ESD), colorectal neoplasms.
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##article.viewOnOriginalSite##About the authors
I M Sayfutdinov
Interregional Clinical-Diagnostic Center
Author for correspondence.
Email: Isayfutdinov@mail.ru
SPIN-code: 6771-5167
Russian Federation, Kazan, Russia
L E Slavin
Interregional Clinical-Diagnostic Center; Kazan State Medical Academy
Email: Isayfutdinov@mail.ru
SPIN-code: 3862-2719
Russian Federation, Kazan, Russia; Kazan, Russia
R N Khayrullin
Interregional Clinical-Diagnostic Center
Email: Isayfutdinov@mail.ru
SPIN-code: 1146-7585
Russian Federation, Kazan, Russia
M S Mukharyamov
Interregional Clinical-Diagnostic Center; Kazan State Medical University
Email: Isayfutdinov@mail.ru
SPIN-code: 1599-4115
Russian Federation, Kazan, Russia; Kazan, Russia
R T Zimagulov
Interregional Clinical-Diagnostic Center
Email: Isayfutdinov@mail.ru
Russian Federation, Kazan, Russia
A I Ivanov
Kazan State Medical Academy; Tatarstan Cancer Center
Email: Isayfutdinov@mail.ru
SPIN-code: 3880-8570
Russian Federation, Kazan, Russia; Kazan, Russia
M V Panasyuk
Interregional Clinical-Diagnostic Center
Email: Isayfutdinov@mail.ru
ORCID iD: 0000-0003-2884-8815
SPIN-code: 8906-2240
Scopus Author ID: 55984522900
ResearcherId: O-9732-2015
Russian Federation, Kazan, Russia
D I Sayfutdinova
Kazan State Medical University
Email: Isayfutdinov@mail.ru
Russian Federation, Kazan, Russia
I A Ivanov
Kazan (Volga region) Federal University
Email: Isayfutdinov@mail.ru
Russian Federation, Kazan, Russia
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