Transanal endoscopic microsurgical submucosal dissection for recurrent rectal adenomas
Background: The local resection of recurrent rectal adenomas is a technically challenging task associated with increased local recurrence rate. Transanal endoscopic microsurgical submucosal dissection (TEM-ESD) uses traction to better expose the fibrotic submucosal layer, and therefore, is a valuabl...
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| Main Authors: | , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
January 31 2023
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| In: |
Digestive diseases
Year: 2023, Volume: 41, Issue: 1, Pages: 89-95 |
| ISSN: | 1421-9875 |
| DOI: | 10.1159/000523672 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1159/000523672 Verlag, lizenzpflichtig, Volltext: https://karger.com/ddi/article/41/1/89/841563/Transanal-Endoscopic-Microsurgical-Submucosal 
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| Author Notes: | Konstantinos Kouladouros, Jörg Baral |
| Summary: | Background: The local resection of recurrent rectal adenomas is a technically challenging task associated with increased local recurrence rate. Transanal endoscopic microsurgical submucosal dissection (TEM-ESD) uses traction to better expose the fibrotic submucosal layer, and therefore, is a valuable alternative for the treatment of such lesions. The aim of our study was to assess the feasibility and outcomes of TEM-ESD for the resection of recurrent rectal adenomas. Methods: We retrospectively analysed all TEM-ESD procedures performed in the Karlsruhe Municipal Hospital between 2012 and 2021 and isolated all cases of recurrent adenomas. Subsequently, we matched these cases 1:1 to TEM-ESD cases for primary rectal adenomas according to the size, localization, and histological type of the lesions and compared the outcomes between the two groups. Results: We identified 19 cases matching our criteria. The median diameter of the lesions was 25 mm and the median operating time 39 min. Macroscopic en bloc resection was achieved in 100% of the cases and histological complete en bloc resection in 78.9%. There was 1 case of conservatively treated postoperative bleeding. After a median follow-up period of 36 months, there was one local recurrence. After comparing those findings to the outcomes of TEM-ESD for primary rectal lesions, we found no significant differences on total operating time, complete en bloc resection rates, adverse events, and local recurrence. Conclusion: TEM-ESD is a feasible therapeutic option for the resection of recurrent rectal adenomas, offering short operating times as well as high en bloc resection and low recurrence rates. |
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| Item Description: | Online veröffentlicht: 24. Februar 2022 Gesehen am 01.07.2024 |
| Physical Description: | Online Resource |
| ISSN: | 1421-9875 |
| DOI: | 10.1159/000523672 |