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The efficacy of endoscopic submucosal dissection for colorectal tumors extending to the dentate line

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Abstract

Purpose

Although endoscopic submucosal dissection (ESD) is becoming the mainstay of the treatment strategies, rather than surgical treatment, for colorectal tumors extending to the dentate line, ESD is technically more difficult. This study was aimed at assessing the usefulness of ESD for the treatment of colorectal tumors extending to the dentate line.

Methods

This study included 531 patients with colorectal tumors who underwent colorectal ESD between 2008 and 2015. They were divided into three groups: rectal tumors extending to the dentate line (anorectal group), those not extending to the dentate line (proximal rectal group), and colonic tumors (colonic group), and a retrospective comparative analysis was carried out.

Results

Of the total patients, 18 (3.4%) had lesions extending to the dentate line area. The procedure times were 103.4 ± 84.0, 80.4 ± 64.3, and 71.8 ± 52.3 min, respectively (P = 0.0318). All the patients in the anorectal group were operated by operators who had performed at least 20 colorectal ESDs (P < 0.0001). No significant difference among the three groups was found in the en bloc resection rate, complete resection rate, or curative resection rate. Although no significant difference in the incidence of perforation was observed among the three groups, intraoperative bleeding was observed in 61% of the patients in the anorectal group (P < 0.0001).

Conclusions

ESD is an effective treatment strategy for colorectal tumors extending to the dentate line. However, it seems that anorectal ESD, which is technically more difficult than colorectal ESD, should be performed by operators with ample experience in performing ESD.

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Author contributions

Conception and design: SM; analysis and interpretation of the data: SM; drafting of the article: SM; critical revision of the article for important intellectual content: HM; final approval of the article: SM and HM.

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Authors and Affiliations

  1. Department of Gastroenterology, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma, Omiya, Saitama, 330-8503, Japan

    Satohiro Matsumoto & Hirosato Mashima

Authors
  1. Satohiro Matsumoto
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  2. Hirosato Mashima
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Corresponding author

Correspondence to Satohiro Matsumoto.

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Ethical consideration

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study was approved by The Etiological Study Ethical Review Board of Saitama Medical Center, Jichi Medical University. For this type of study, formal consent is not required.

Funding

The authors have no support or funding to report.

Competing interests

The authors declare that they have no conflict of interest.

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Matsumoto, S., Mashima, H. The efficacy of endoscopic submucosal dissection for colorectal tumors extending to the dentate line. Int J Colorectal Dis 32, 831–837 (2017). https://doi.org/10.1007/s00384-017-2775-y

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  • DOI: https://doi.org/10.1007/s00384-017-2775-y

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