期刊
WORLD JOURNAL OF GASTROENTEROLOGY
卷 15, 期 48, 页码 6086-6090出版社
BAISHIDENG PUBLISHING GROUP INC
DOI: 10.3748/wjg.15.6086
关键词
Balloon overtube; Colorectal neoplasm; Early colorectal cancer; En bloc tumor excision; Endoscopic submucosal dissection; Laterally spreading tumor
资金
- Jikei University School of Medicine
- Kanto Medical Center NTT EC
AIM: To evaluate the usefulness of a balloon overtube to assist colorectal endoscopic submucosal dissection (ESD) using a gastroscope. METHODS: The results of 45 consecutive patients who underwent colorectal ESD were analyzed in a single tertiary endoscopy center. In preoperative evaluation of access to the lesion, difficulties were experienced in the positioning and stabilization of a gastroscope in 15 patients who were thus assigned to the balloon-guided ESD group. A balloon overtube was placed with a gastroscope to provide an endoscopic channel to the lesion in cases with preoperatively identified difficulties related to accessibility. Colorectal ESD was performed following standard procedures. A submucosal fluid bleb was created with hyaluronic acid solution. A circumferential mucosal incision was made to marginate the lesion. The isolated lesion was finally excised from the deeper layers with repetitive electrosurgical dissections with needle knives. The success of colorectal ESD, procedural feasibility, and procedure-related complications were the main outcomes and measurements. RESULTS: The overall en bloc excision rate of colorectal ESD during this study at our institution was 95.6%.,En bloc excision of the lesion was successfully achieved in 13 of the 15 patients (86.7%) in the balloon overtube-guided colorectal ESD group, which was comparable to the results of the standard ESD group with better accessibility to the lesion (30/30, 100%, not statistically significant). CONCLUSION: Use of a balloon overtube can improve access to the lesion and facilitate scope manipulation for colorectal ESD. (C) 2009 The WJG Press and Baishideng. All rights reserved.
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