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Surgical Endoscopy

, Volume 25, Issue 1, pp 255–260 | Cite as

Treatment strategy for recurrent or residual colorectal tumors after endoscopic resection

  • Taku Sakamoto
  • Yutaka SaitoEmail author
  • Takahisa Matsuda
  • Shusei Fukunaga
  • Takeshi Nakajima
  • Takahiro Fujii
Article

Abstract

Background

Piecemeal resection of colorectal neoplasms is associated with a higher risk of recurrent or residual tumors, but nearly all such cases can be cured by additional endoscopic resection (ER). Although the adoption of endoscopic submucosal dissection (ESD) for colorectal neoplasm is continuing, the safety of this treatment for recurrent or residual tumors has not been fully assessed. We evaluated salvage therapy for the treatment of recurrent or residual tumors, and propose an endoscopic treatment strategy for these tumors.

Methods

This retrospective study was conducted for 60 consecutive patients who had with locally recurrent or residual tumor after ER between January 2004 and October 2005. Endoscopic treatment strategy, treatment results, complications and clinical outcomes were recorded.

Results

Among 69 lesions in 60 patients, 67 were treated endoscopically, whereas 2 required surgical treatment. Of these 67, 87% (58/67) were resected by endoscopic mucosal resection (EMR) and 13% (9/67) by ESD. En bloc resection rate was 39% (23/58) in the EMR group and 56% (5/9) in the ESD group. One limitation of this study is that it was a single-center retrospective analysis.

Conclusions

ESD is safe and effective for the treatment of recurrent or residual colorectal tumors. However, because of its technical difficulty, the en bloc resection rate is lower than that for the treatment of nonrecurrent lesions.

Keywords

Colonoscopy Endoscopic submucosal dissection Recurrent or residual tumor 

Abbreviations

ER

Endoscopic resection

EMR

Endoscopic mucosal resection

EPMR

Endoscopic piecemeal mucosal resection

ESD

Endoscopic submucosal dissection

TEM

Transanal endoscopic microsurgery

HGD

High grade dysplasia

Notes

Disclosures

Taku Sakamoto, Yutaka Saito, Takahisa Matsuda, Shusei Fukunaga, Takeshi Nakajima, and Takahiro Fujii have no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Taku Sakamoto
    • 1
  • Yutaka Saito
    • 1
    Email author
  • Takahisa Matsuda
    • 1
  • Shusei Fukunaga
    • 1
  • Takeshi Nakajima
    • 1
  • Takahiro Fujii
    • 1
    • 2
  1. 1.Endoscopy DivisionNational Cancer Center HospitalTokyoJapan
  2. 2.TF ClinicTokyoJapan

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