講演情報
[SY8-6]Evaluation of the effectiveness of underwater colorectal ESD
*Yuko Miura1, Yosuke Tsuji1, Mithuhiro Fujishiro1 (1. Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Japan)
Objective
Underwater colorectal endoscopic submucosal dissection (uESD) has been reported to facilitate submucosal dissection by utilizing mucosal buoyancy and improving procedural visibility. This study evaluated the effectiveness of uESD by comparing treatment outcomes before and after its introduction by intermediate-level endoscopists.
Methods
Patients with lesions up to pT1 carcinoma who underwent colorectal ESD by four endoscopists (experience: 30–150 cases) were included. Cases were divided into three groups for each endoscopist: pre-introduction, early introduction phase (first 10 uESD cases), and late introduction phase (subsequent 10 cases). Outcomes included dissection speed, R0 resection rate, self-completion rate, and adverse events.
Results
A total of 122 cases were analyzed. A tendency toward a higher proportion of T1 cancers was observed in the two groups after uESD introduction. In the comparison between the pre introduction and early introduction phase groups, there were no significant differences in dissection speed (p = 0.96), R0 resection rate (59.0% vs. 62.5%, p = 0.82), or perforation rate (5.1% vs. 10.0%, p = 0.68). However, the self-completion rate tended to be higher in the early introduction group (79.5% vs. 87.5%, p = 0.38).
In the comparison between the early and late introduction phase groups, no significant differences were observed in the R0 resection rate (62.5% vs. 74.4%, p = 0.34) or self-completion rate (87.5% vs. 90.7%, p = 0.73). In contrast, dissection speed showed a tendency to be higher in the late introduction phase group (11.05 ± 6.94 vs. 13.53 ± 7.11 mm²/min, p = 0.11), while the perforation rate tended to be lower (10.0% vs. 2.3%, p = 0.19).
Conclusions
The introduction of uESD improved the self-completion rate among intermediate-level endoscopists. Moreover, procedural proficiency in uESD appeared to be achieved after approximately 10 cases, with a subsequent tendency toward further improvement in treatment outcomes. These findings suggest that the introduction of uESD may further enhance therapeutic outcomes in colorectal ESD
Underwater colorectal endoscopic submucosal dissection (uESD) has been reported to facilitate submucosal dissection by utilizing mucosal buoyancy and improving procedural visibility. This study evaluated the effectiveness of uESD by comparing treatment outcomes before and after its introduction by intermediate-level endoscopists.
Methods
Patients with lesions up to pT1 carcinoma who underwent colorectal ESD by four endoscopists (experience: 30–150 cases) were included. Cases were divided into three groups for each endoscopist: pre-introduction, early introduction phase (first 10 uESD cases), and late introduction phase (subsequent 10 cases). Outcomes included dissection speed, R0 resection rate, self-completion rate, and adverse events.
Results
A total of 122 cases were analyzed. A tendency toward a higher proportion of T1 cancers was observed in the two groups after uESD introduction. In the comparison between the pre introduction and early introduction phase groups, there were no significant differences in dissection speed (p = 0.96), R0 resection rate (59.0% vs. 62.5%, p = 0.82), or perforation rate (5.1% vs. 10.0%, p = 0.68). However, the self-completion rate tended to be higher in the early introduction group (79.5% vs. 87.5%, p = 0.38).
In the comparison between the early and late introduction phase groups, no significant differences were observed in the R0 resection rate (62.5% vs. 74.4%, p = 0.34) or self-completion rate (87.5% vs. 90.7%, p = 0.73). In contrast, dissection speed showed a tendency to be higher in the late introduction phase group (11.05 ± 6.94 vs. 13.53 ± 7.11 mm²/min, p = 0.11), while the perforation rate tended to be lower (10.0% vs. 2.3%, p = 0.19).
Conclusions
The introduction of uESD improved the self-completion rate among intermediate-level endoscopists. Moreover, procedural proficiency in uESD appeared to be achieved after approximately 10 cases, with a subsequent tendency toward further improvement in treatment outcomes. These findings suggest that the introduction of uESD may further enhance therapeutic outcomes in colorectal ESD