期刊
COLORECTAL DISEASE
卷 23, 期 8, 页码 2100-2107出版社
WILEY
DOI: 10.1111/codi.15746
关键词
endoscopic submucosal dissection; focality; visible lesions; inflammatory bowel disease
This study aimed to investigate the safety, feasibility, and oncological outcomes of endoscopic submucosal dissection (ESD) in patients with inflammatory bowel disease (IBD). The results showed that ESD was safe and effective for complete removal of neoplastic lesions in IBD patients, allowing for ongoing endoscopic surveillance and organ preservation.
Aim Experience of endoscopic submucosal dissection (ESD) for colorectal lesions in the setting of inflammatory bowel disease (IBD) remains limited. The aim of this work was to determine the safety, feasibility and oncological outcomes of ESD in patients with IBD. Method A retrospective review of all adult patients (>= 18 years) with a known diagnosis of either ulcerative colitis (UC) or Crohn's disease (CD) who underwent advanced colonoscopy and ESD between 1 January 2014 and 1 October 2020. Data collected included patient demographics, disease characteristics, pathological variables and procedure-related complication rates. Results A total of 25 patients were included: 19 (76%) were male with a median age of 63 years and disease duration of more than 10 years. Sixteen had UC and nine had CD; the majority were taking corticosteroids, immunomodulators or monoclonal antibodies at the time of ESD. The median procedure time was 41 min and the majority (n = 18; 72%) utilized chromoendoscopy. The median lesion size was 30 mm: eight had low-grade dysplasia, nine had high-grade dysplasia and three had adenocarcinoma and underwent oncological resection. None had surgical intervention for complication of ESD or perforation. A total of 23 (88%) had a complete R0 resection. Over a median follow-up of 19 months, three were found to have dysplasia excised in polyps and none had subsequent adenocarcinoma. Conclusion ESD in the setting of IBD is safe and effective for complete removal of large neoplastic lesions, allowing for ongoing endoscopic surveillance and organ preservation rather than surgical intervention.
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