European experience of colorectal endoscopic submucosal dissection: a systematic review of clinical efficacy and safety

Henrik Thorlacius, Carl Fredrik Rönnow, E. Tóth

Research output: Contribution to journalReview article

3 Citations (Scopus)

Abstract

Background: Endoscopic submucosal dissection (ESD) is an advanced method allowing en bloc resection of large and complex lesions in colon and rectum. Herein, the European experience of colorectal ESD was systematically reviewed in the medical literature to determine the clinical efficacy and safety of colorectal ESD in Europe. Material and methods: A systematic search of PubMed for full-text studies including more than 20 cases of colorectal ESD emanating from European centres was performed. Data were independently extracted by two authors using predefined data fields, including efficacy and safety. Results: We included 15 studies containing a total of 1404 colorectal ESD cases (41% in the colon) performed between 2007 and 2018. Lesion size was 40 mm (range 24–59 mm) and procedure time was 102 min (range 48–176 min). En bloc resection rate was 83% (range 67–93%) and R0 resection rate was 70% (range 35–91%). Perforation rate was 7% (range 0–19%) and bleeding rate was 5% (range 0–12%). The percentage of ESD cases undergoing emergency surgery was 2% (range 0–6%). Additional elective surgery was performed in 3% of all cases due to histopathological findings showing deep submucosal invasion or more advanced cancer. The recurrence rate was 4% (range 0–12%) after a median follow-up time of 12 months (range 3–24 months). Conclusions: This review shows that ESD is effective and safe for treating large and complex colorectal lesions in Europe although there is room for improvement. Thus, it is important to develop standardized and high-quality educational programs in colorectal ESD in Europe.

Original languageEnglish
Pages (from-to)S10-S14
JournalActa Oncologica
Volume58
Issue numbersup1
DOIs
Publication statusPublished - Apr 1 2019

Fingerprint

Safety
Colon
Endoscopic Mucosal Resection
Rectum
PubMed
Emergencies
Hemorrhage
Recurrence
Neoplasms

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Radiology Nuclear Medicine and imaging

Cite this

European experience of colorectal endoscopic submucosal dissection : a systematic review of clinical efficacy and safety. / Thorlacius, Henrik; Rönnow, Carl Fredrik; Tóth, E.

In: Acta Oncologica, Vol. 58, No. sup1, 01.04.2019, p. S10-S14.

Research output: Contribution to journalReview article

@article{c897067419bf4767ad0ed8ad0fb0da94,
title = "European experience of colorectal endoscopic submucosal dissection: a systematic review of clinical efficacy and safety",
abstract = "Background: Endoscopic submucosal dissection (ESD) is an advanced method allowing en bloc resection of large and complex lesions in colon and rectum. Herein, the European experience of colorectal ESD was systematically reviewed in the medical literature to determine the clinical efficacy and safety of colorectal ESD in Europe. Material and methods: A systematic search of PubMed for full-text studies including more than 20 cases of colorectal ESD emanating from European centres was performed. Data were independently extracted by two authors using predefined data fields, including efficacy and safety. Results: We included 15 studies containing a total of 1404 colorectal ESD cases (41{\%} in the colon) performed between 2007 and 2018. Lesion size was 40 mm (range 24–59 mm) and procedure time was 102 min (range 48–176 min). En bloc resection rate was 83{\%} (range 67–93{\%}) and R0 resection rate was 70{\%} (range 35–91{\%}). Perforation rate was 7{\%} (range 0–19{\%}) and bleeding rate was 5{\%} (range 0–12{\%}). The percentage of ESD cases undergoing emergency surgery was 2{\%} (range 0–6{\%}). Additional elective surgery was performed in 3{\%} of all cases due to histopathological findings showing deep submucosal invasion or more advanced cancer. The recurrence rate was 4{\%} (range 0–12{\%}) after a median follow-up time of 12 months (range 3–24 months). Conclusions: This review shows that ESD is effective and safe for treating large and complex colorectal lesions in Europe although there is room for improvement. Thus, it is important to develop standardized and high-quality educational programs in colorectal ESD in Europe.",
author = "Henrik Thorlacius and R{\"o}nnow, {Carl Fredrik} and E. T{\'o}th",
year = "2019",
month = "4",
day = "1",
doi = "10.1080/0284186X.2019.1568547",
language = "English",
volume = "58",
pages = "S10--S14",
journal = "Acta Oncologica",
issn = "0284-186X",
publisher = "Informa Healthcare",
number = "sup1",

}

TY - JOUR

T1 - European experience of colorectal endoscopic submucosal dissection

T2 - a systematic review of clinical efficacy and safety

AU - Thorlacius, Henrik

AU - Rönnow, Carl Fredrik

AU - Tóth, E.

PY - 2019/4/1

Y1 - 2019/4/1

N2 - Background: Endoscopic submucosal dissection (ESD) is an advanced method allowing en bloc resection of large and complex lesions in colon and rectum. Herein, the European experience of colorectal ESD was systematically reviewed in the medical literature to determine the clinical efficacy and safety of colorectal ESD in Europe. Material and methods: A systematic search of PubMed for full-text studies including more than 20 cases of colorectal ESD emanating from European centres was performed. Data were independently extracted by two authors using predefined data fields, including efficacy and safety. Results: We included 15 studies containing a total of 1404 colorectal ESD cases (41% in the colon) performed between 2007 and 2018. Lesion size was 40 mm (range 24–59 mm) and procedure time was 102 min (range 48–176 min). En bloc resection rate was 83% (range 67–93%) and R0 resection rate was 70% (range 35–91%). Perforation rate was 7% (range 0–19%) and bleeding rate was 5% (range 0–12%). The percentage of ESD cases undergoing emergency surgery was 2% (range 0–6%). Additional elective surgery was performed in 3% of all cases due to histopathological findings showing deep submucosal invasion or more advanced cancer. The recurrence rate was 4% (range 0–12%) after a median follow-up time of 12 months (range 3–24 months). Conclusions: This review shows that ESD is effective and safe for treating large and complex colorectal lesions in Europe although there is room for improvement. Thus, it is important to develop standardized and high-quality educational programs in colorectal ESD in Europe.

AB - Background: Endoscopic submucosal dissection (ESD) is an advanced method allowing en bloc resection of large and complex lesions in colon and rectum. Herein, the European experience of colorectal ESD was systematically reviewed in the medical literature to determine the clinical efficacy and safety of colorectal ESD in Europe. Material and methods: A systematic search of PubMed for full-text studies including more than 20 cases of colorectal ESD emanating from European centres was performed. Data were independently extracted by two authors using predefined data fields, including efficacy and safety. Results: We included 15 studies containing a total of 1404 colorectal ESD cases (41% in the colon) performed between 2007 and 2018. Lesion size was 40 mm (range 24–59 mm) and procedure time was 102 min (range 48–176 min). En bloc resection rate was 83% (range 67–93%) and R0 resection rate was 70% (range 35–91%). Perforation rate was 7% (range 0–19%) and bleeding rate was 5% (range 0–12%). The percentage of ESD cases undergoing emergency surgery was 2% (range 0–6%). Additional elective surgery was performed in 3% of all cases due to histopathological findings showing deep submucosal invasion or more advanced cancer. The recurrence rate was 4% (range 0–12%) after a median follow-up time of 12 months (range 3–24 months). Conclusions: This review shows that ESD is effective and safe for treating large and complex colorectal lesions in Europe although there is room for improvement. Thus, it is important to develop standardized and high-quality educational programs in colorectal ESD in Europe.

UR - http://www.scopus.com/inward/record.url?scp=85064081460&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85064081460&partnerID=8YFLogxK

U2 - 10.1080/0284186X.2019.1568547

DO - 10.1080/0284186X.2019.1568547

M3 - Review article

C2 - 30724676

AN - SCOPUS:85064081460

VL - 58

SP - S10-S14

JO - Acta Oncologica

JF - Acta Oncologica

SN - 0284-186X

IS - sup1

ER -