- 作者：Jung Ho Bae ; MD ; Dong-Hoon Yang ; MD ; Seungyun Lee ; MS ; Jae Seung Soh ; MD ; Seohyun Lee ; MD ; Ho-Su Lee ; MD ; Hyo Jeong Lee ; MD ; Sang Hyoung Park ; MD ; Kyung-Jo Kim ; MD ; Byong Duk Ye ; MD ; Seung-Jae Myung ; MD ; Suk-Kyun Yang ; MD ; Jeong-Sik Byeon ; MD
- 关键词：ESD ; endoscopic submucosal dissection
- 刊名：Gastrointestinal Endoscopy
- 出版年：2016
- 出版时间：March 2016
- 年：2016
- 卷：83
- 期：3
- 页码：584-592
- 全文大小：1401 K
Methods
We prospectively enrolled 70 patients with colorectal neoplasia ≥20 mm. The patients were randomized to receive either ESD (36 patients) or optimized hybrid ESD (34 patients). In the optimized hybrid ESD group, snare resection was performed after an adequate amount of submucosal dissection. The primary outcome was procedure time. Secondary outcomes were en bloc and complete resection rates and adverse event rates.
Results
ESD could not be completed in 5 patients (13.9%) in the ESD group because of technical difficulties. We tried hybrid ESD to finish the resection, and en bloc resection was achieved in 4 patients (80%). The mean procedure time was shorter in the optimized hybrid ESD group compared with the ESD group (27.4 vs 40.6 minutes; P = .005). The en bloc resection rates were similar (94.1% vs 100%; P = .493), as were the complete resection rates (91.2% vs 93.5%; P > .999) and perforation rates (3 patients [8.8%] vs 2 patients [6.5%]; P > .999).
Conclusions
Optimized hybrid ESD achieves shorter procedure times than ESD, with similar en bloc resection rates and adverse event rates. Optimized hybrid ESD in the colorectum may offer an easy alternative to colorectal ESD and a rescue method for failed ESD cases. (Clinical trial registration number: