Feasibility of endoscopic submucosal dissection for gastric and colorectal lesions: Initial experience from the Gastrocentro – Unicamp

• Published in: Clinics (São Paulo, Brazil) Vol. 68; no. 2; pp. 141 - 145
• Main Authors: Meirelles Santos, Jose Olympio, Miyajima, Nelson, Carvalho, Rita, Leal, Raquel Franco, de Lourdes Setsuko Ayrizomo, Maria, Coy, Cláudio Saddy Rodrigues
• Format: Journal Article
• Language: English
• Published: Brazil Elsevier España, S.L.U 01-01-2013; Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo; Faculdade de Medicina / USP; Elsevier España
• Subjects: Aged; Biopsy; Brazil; Clinical Science; Colonic Neoplasms - pathology; Colonic Neoplasms - surgery; Colorectal Tumor; Dissection - methods; Early Gastric Cancer; Endoscopic Mucosal Resection; Endoscopic Submucosal Dissection; Endoscopy; Feasibility Studies; Female; Gastric Mucosa - injuries; Gastric Mucosa - pathology; Gastric Mucosa - surgery; Hospitals, Special; Humans; Intestinal Mucosa - injuries; Intestinal Mucosa - pathology; Intestinal Mucosa - surgery; Male; MEDICINE, GENERAL & INTERNAL; Middle Aged; Rectal Neoplasms - pathology; Rectal Neoplasms - surgery; Reproducibility of Results; Stomach Neoplasms - surgery; Treatment Outcome; Brazil; Early Gastric Cancer; Colorectal Tumor; Endoscopic Mucosal Resection; Endoscopy; Endoscopic Submucosal Dissection
• ISSN: 1807-5932; 1980-5322; 1980-5322
• DOI: 10.6061/clinics/2013(02)OA04

Endoscopic submucosal dissection is a technique developed in Japan for en bloc resection with a lower rate of recurrence. It is considered technically difficult and performed only in specialized centers. This study sought to report the initial experience from the Gastrocentro – Campinas State University for the treatment of gastric and colorectal lesions by endoscopic submucosal dissection.
The guidelines of the Japanese Association of Gastric Cancer were used as evaluative criteria. For colorectal lesions, the recommended standards proposed by Uraoka et al. and Saito et al. were employed. The practicability of the method, the development of complications and histological analysis of the specimens were evaluated.
Sixteen patients underwent endoscopic submucosal dissection from June 2010 to April 2011; nine patients were treated for gastric lesions, and seven were treated for colorectal lesions. The average diameter of the gastric lesions was 28.6 mm, and the duration of resection was 103 min without complications. All lesions presented lesion-free margins. Of the seven colorectal tumors, four were located in the rectum and three were located in the colon. The average size was 26 mm, and the average procedure time was 163 min. Two complications occurred during the rectal resection procedures: perforation, which was treated with an endoscopic clip, and controlled bleeding. One of the lesions presented a compromised lateral margin without relapse after 90 days. Depth margins were all free of lesions.
Endoscopic submucosal dissection at our institution achieved high success rates, with few complications in preliminary procedures. The procedure also made appropriate lesion staging possible.