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Chinese Journal of Colorectal Diseases(Electronic Edition) ›› 2014, Vol. 03 ›› Issue (06): 447-452. doi: 10.3877/cma.j.issn.2095-3224.2014.06.07

Special Issue:

• Original Article • Previous Articles     Next Articles

Clinical value of endoscopic submucosal dissection for treating laterally spreading tumor in the rectum

Chen ZHAGN1, Mei-dong XU1,(), Li-qing Yao1, Ping-hong ZHOU1, Yun-shi ZHONG1, Yi-qun ZHANG1, Wei-feng CHEN1, Wen-zheng QIN1, Jian-wei HU1, Quan-lin LI1   

  1. 1. Department of Endoscopy Center, Zhongshan Hospital, Fudan University, Shanghai 200032, China
  • Received:2014-12-07 Online:2014-12-25 Published:2014-12-25
  • Contact: Mei-dong XU
  • About author:
    Corresponding author, Xu Mei-dong, Email:

Abstract:

Objective

This study aims to investigate the clinicopathological features of rectal laterally spreading tumor(LST)and assess the effect and safety of endoscopic submucosal dissection(ESD)for treating rectal LSTs.

Methods

Data of 120 cases of rectal LSTs, which were treated by ESD in endoscopy center in Zhongshan Hospital, Fudan University from April 2008 to January 2012, were collected.All LSTs were divided into different types according to surface morphology under endoscopic view.Location, size and morphological characteristics of each subtype of LST were studied.Clinicopathological features of LST, resection rate of ESD, procedure time, complications and recurrence rate were analyzed.

Results

Among 120 LSTs in the rectum, 84 cases were LST-G(84/120, 70%), 36 cases were LST-NG(36/120, 30%). Average size of the lesion was 35 mm.Villioustublar adenoma accounted for 38.3%, high grade intraepithelial neoplasia 28.3% and submucosal carcinoma 7.5%.The average procedure time was 51.8±28.16(17-110)min.En bloc resection rate was 98.3%, complete resection rate was 95.0% and en bloc R0 curative resection rate was 90.8%.Bleeding after ESD developed in 5 cases(4.2%), perforation developed in 4 cases(3.3%). The average time of the follow-up was 32.6 months, recurrence rate was 0.8%.

Conclusions

High malignant potential existed in LSTs, which were lager than 2 cm.ESD was an effective and safe treatment for rectal LSTs for its high en bloc resection rate and low recurrence rate.

Key words: Rectal neoplasms, Endoscopes, gastrointestinal, Laterally spreading tumors, Endoscopic submucosal dissection

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