Abstract：
BACKGROUND: Endoscopic sub-mucosal dissection (ESD) is an established endoscopic modality for the management of colorectal polyps. However, there are no studies regarding the outcomes of ESD from India. In this study, we aimed at evaluating the outcomes of ESD in patients with adenomatous polyps in the colon and rectum.
METHODS: Data of consecutive patients who underwent ESD for colorectal polyps from 2018 to 2021 were analyzed, retrospectively. The primary outcome of the study was the technical success of ESD. The secondary outcomes included the rate of histologically complete resection (R0), adverse events and recurrence.
RESULTS: Seventy patients (63.5 years, 60% males) underwent ESD for polyps in colon and rectum. A majority were located in rectum (80%) and sigmoid colon (15.7%). Narrow band classification of the polyps was Japanese Narrow Band Imaging Expert Team (JNET)-2a in 50 (71.4%) and JNET-2b in 13 (18.6%) patients. ESD was technically successful in 64 (91.4%) patients using conventional technique (72.8%) and pocket or tunnelling technique (18.6%). There were no major adverse events. Histologically RO was achieved in 58 (82.8%) patients and deep sub-mucosal invasion was noted in 12 patients. At a median follow-up of 19 (interquartile range [IQR] 15-27) months, recurrence was noticed in four (5.7%) patients all of which could be managed endoscopically.
CONCLUSIONS: ESD, performed at a tertiary care centre in India, yields high rates of technical success and histologically R0, with a relatively low incidence of adverse events and recurrences.
METHODS: Data of consecutive patients who underwent ESD for colorectal polyps from 2018 to 2021 were analyzed, retrospectively. The primary outcome of the study was the technical success of ESD. The secondary outcomes included the rate of histologically complete resection (R0), adverse events and recurrence.
RESULTS: Seventy patients (63.5 years, 60% males) underwent ESD for polyps in colon and rectum. A majority were located in rectum (80%) and sigmoid colon (15.7%). Narrow band classification of the polyps was Japanese Narrow Band Imaging Expert Team (JNET)-2a in 50 (71.4%) and JNET-2b in 13 (18.6%) patients. ESD was technically successful in 64 (91.4%) patients using conventional technique (72.8%) and pocket or tunnelling technique (18.6%). There were no major adverse events. Histologically RO was achieved in 58 (82.8%) patients and deep sub-mucosal invasion was noted in 12 patients. At a median follow-up of 19 (interquartile range [IQR] 15-27) months, recurrence was noticed in four (5.7%) patients all of which could be managed endoscopically.
CONCLUSIONS: ESD, performed at a tertiary care centre in India, yields high rates of technical success and histologically R0, with a relatively low incidence of adverse events and recurrences.
摘要：
背景：内镜黏膜下剥离术（ESD）是一种已建立的内镜治疗结直肠息肉的方法。然而,印度没有关于可持续发展教育结果的研究。在这项研究中,我们旨在评估结肠和直肠腺瘤性息肉患者的ESD结局.
方法：分析2018年至2021年连续接受大肠息肉ESD治疗的患者数据，回顾性。该研究的主要结果是ESD的技术成功。次要结果包括组织学完全切除率（R0），不良事件和复发。
结果：70名患者（63.5岁，60％的男性）接受了结肠和直肠息肉的ESD。大多数位于直肠（80％）和乙状结肠（15.7％）。息肉的窄带分类是日本窄带成像专家组（JNET）-2a在50（71.4％）和JNET-2b在13（18.6％）患者。使用常规技术（72.8％）和口袋或隧道技术（18.6％）的64例（91.4％）患者中，ESD在技术上是成功的。无重大不良事件发生。58例（82.8％）患者在组织学上实现了RO，在12例患者中发现了深粘膜下浸润。在中位随访19个月（四分位距[IQR]15-27个月），在4例(5.7%)患者中发现复发,所有这些患者均可通过内镜治疗.
结论：ESD，在印度的一个三级护理中心，技术成功率和组织学R0率高,不良事件和复发率相对较低.
方法：分析2018年至2021年连续接受大肠息肉ESD治疗的患者数据，回顾性。该研究的主要结果是ESD的技术成功。次要结果包括组织学完全切除率（R0），不良事件和复发。
结果：70名患者（63.5岁，60％的男性）接受了结肠和直肠息肉的ESD。大多数位于直肠（80％）和乙状结肠（15.7％）。息肉的窄带分类是日本窄带成像专家组（JNET）-2a在50（71.4％）和JNET-2b在13（18.6％）患者。使用常规技术（72.8％）和口袋或隧道技术（18.6％）的64例（91.4％）患者中，ESD在技术上是成功的。无重大不良事件发生。58例（82.8％）患者在组织学上实现了RO，在12例患者中发现了深粘膜下浸润。在中位随访19个月（四分位距[IQR]15-27个月），在4例(5.7%)患者中发现复发,所有这些患者均可通过内镜治疗.
结论：ESD，在印度的一个三级护理中心，技术成功率和组织学R0率高,不良事件和复发率相对较低.
