Retrospective analysis of the outcomes of endoscopic submucosal dissection for the diagnosis and treatment of subepithelial lesions in a center with high expertise

• Type: Article in International Scientific Journal
• Date: 2022

Authors

João Santos-Antunes (Author) FMUP; Marques, M (Author) Other; Morais, R (Author) Other; Baldaque Silva, F (Author) Other; Vilas Boas, F (Author) Other; Moutinho Ribeiro, P (Author) Other; Lopes, S (Author) Other; Carneiro F (Author) FMUP; Macedo, G (Author) Other

Journal

The Journal is awaiting validation by the Administrative Services.

Title: ANNALS OF GASTROENTEROLOGY

Vol. 35

Pages: 68-73

ISSN: 1108-7471

Publisher: HELLENIC SOC GASTROENTEROLOGY

Indexing

ISI Web of Knowledge - 0 Citations

Scopus - 1 Citation

Other information

Authenticus ID: P-00V-R1E

DOI: 10.20524/aog.2021.0675

Abstract (EN): Background Use of endoscopic submucosal dissection (ESD) for the diagnosis and treatment of subepithelial lesions (SELs) is limited in the West, and the best approach for these lesions is still debated. In this study we describe our experience regarding the usefulness, safety and outcomes of ESD for SELs. Method We performed a retrospective analysis of ESD in the diagnosis and treatment of SELs between November 2010 and February 2021. Results A total of 634 ESDs were reviewed. Fifty-five (9%) were performed in SELs, 6 in the esophagus, 34 in the stomach, and 15 in the rectum. ESD was technically successful in 53 lesions (96%). Most of them (82%) had previous endoscopic ultrasound evaluation, but only 20% had a histological diagnosis previous to the ESD. Neuroendocrine tumors, gastrointestinal stromal tumors, and granular cell tumors accounted for 38% of the procedures, with a 100% rate of en bloc resection and 65% of R0 resection; the main criterion for non-curative resection was a deep positive margin, and none of the patients treated with complementary surgery had lesions on the gastrointestinal wall. Most of the procedures (62%) were performed in lesions with very low malignant potential, providing the definitive diagnosis of SELs where the previous diagnostic workup was inconclusive. We had a total of 2 delayed bleedings and 1 perforation, all treated endoscopically. Conclusion Our real-life experience showed that ESD can be an effective and safe diagnostic tool for undetermined SELs, as well as an effective treatment for neoplastic SELs with malignant potential.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 6