IDDF2018-ABS-0142 Comparison of differences of ESD with different diameters of early stage colorectal cancers and precancerous colorectal lesions

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Abstract

Background

With the increase of diameters of colorectal tumours, procedure time of colorectal endoscopic submucosal dissection (CR – ESD) gradually prolonged. The aim of this study was to discuss the differences of ESD for colorectal tumours with different diameters, which was expected to provide some help for clinical work.

Methods

This was a retrospective study of clinical data. From October 2012 to December 2015, we examined a total of 210 patients who were treated by an endoscopic procedure for colorectal tumours in the Endoscopy Centre, the PLA Army General Hospital. The lesions were divided into two groups according to different diameters (≥4.0 cm VS <4.0 cm) for comparative analysis of related factors.

Results

The average procedure time of ESD of 210 colorectal tumour cases was 50.3±42.7 min and the average size was 7.98±10.84 cm2. En bloc resection rate was 91.4%, R0 resection rate was 90.5%, and the curative resection rate was 90.5%. Perforation rate was 5.2% (11/210), and the late-onset haemorrhage rate was 0.5% (1/210). Compared with lesions with the diameters of <4 cm, tumours with diameters greater than 4 cm required longer resection time (79.63±53.91 min vs 35.28±24.99 min; p<0.001); the lesions mainly located in the rectum (61.97%); LST of mixed granular/nongranular type accounted for 54.93%; en bloc resection rate, complete resection rate and curative resection rate of the tumours with diameters≥4.0 cm was lower than those of <4 cm, the differences of complete resection rate was statistically significant (85.92% vs. 94.24%; p=0.041). The perforation rate was higher (7.04%) in the group with tumour sizes≥4.0 cm, but the difference was not statistically significant.

Conclusions

ESDs of colorectal tumours with diameters greater than 4 cm require longer time, and the operation risk is higher. The operators should be more careful with non-rectal lesions.

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