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2 "Nobuaki Ikezawa"
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Original Articles
Feasibility and safety of endoscopic submucosal dissection for lesions in proximity to a colonic diverticulum
Nobuaki Ikezawa, Takashi Toyonaga, Shinwa Tanaka, Tetsuya Yoshizaki, Toshitatsu Takao, Hirofumi Abe, Hiroya Sakaguchi, Kazunori Tsuda, Satoshi Urakami, Tatsuya Nakai, Taku Harada, Kou Miura, Takahisa Yamasaki, Stuart Kostalas, Yoshinori Morita, Yuzo Kodama
Clin Endosc 2022;55(3):417-425.   Published online May 12, 2022
DOI: https://doi.org/10.5946/ce.2021.245
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: Endoscopic submucosal dissection (ESD) for diverticulum-associated colorectal lesions is generally contraindicated because of the high risk of perforation. Several studies on patients with such lesions treated with ESD have been reported recently. However, the feasibility and safety of ESD for lesions in proximity to a colonic diverticulum (D-ESD) have not been fully clarified. The aim of this study was to evaluate the feasibility and safety of D-ESD.
Methods
D-ESD was defined as ESD for lesions within approximately 3 mm of a diverticulum. Twenty-six consecutive patients who underwent D-ESD were included. Two strategic approaches were used depending on whether submucosal dissection of the diverticulum-related part was required (strategy B) or not (strategy A). Treatment outcomes and adverse events associated with each strategy were analyzed.
Results
The en bloc resection rate was 96.2%. The rates of R0 and curative resection in strategies A and B were 80.8%, 73.1%, 84.6%, and 70.6%, respectively. Two cases of intraoperative perforation and one case of delayed perforation occurred. The delayed perforation case required emergency surgery, but the other cases were managed conservatively.
Conclusions
D-ESD may be a feasible treatment option. However, it should be performed in a high-volume center by expert hands because it requires highly skilled endoscopic techniques.

Citations

Citations to this article as recorded by  
  • Endoscopic submucosal dissection for diverticulum using combination of countertraction and circumferential-inversion method
    Hiroshi Takayama, Yoshinori Morita, Toshitatsu Takao, Douglas Motomura, Madoka Takao, Takashi Toyonaga, Yuzo Kodama
    Endoscopy.2024; 56(S 01): E91.     CrossRef
  • Traction-assisted endoscopic submucosal dissection for resection of ileocecal valve neoplasia: a French retrospective multicenter case series
    Clara Yzet, Timothée Wallenhorst, Jérémie Jacques, Mariana Figueiredo Ferreira, Jérôme Rivory, Florian Rostain, Louis-Jean Masgnaux, Jean Grimaldi, Romain Legros, Pierre Lafeuille, Jérémie Albouys, Fabien Subtil, Marion Schaefer, Mathieu Pioche
    Endoscopy.2024; 56(10): 790.     CrossRef
  • The role of cap-assisted endoscopy and its future implications
    Sol Kim, Bo-In Lee
    Clinical Endoscopy.2024; 57(3): 293.     CrossRef
  • Strategies to successfully complete complex ESD in the colon
    David Barquero Declara, Alex Blasco Pelicano, Claudia Berbel Comas, Alfredo Mata Bilbao
    Endoscopy International Open.2024; 12(07): E914.     CrossRef
  • Novel technique “short myotomy” during endoscopic submucosal dissection for a diverticulum‐associated colonic lesion
    Ryosuke Kobayashi, Kingo Hirasawa, Shin Maeda
    Digestive Endoscopy.2024;[Epub]     CrossRef
  • Successful planned piecemeal endoscopic resection using gel immersion and an over-the-scope clip for a lesion extensively extended into the colonic diverticulum
    Tomoaki Tashima, Takahiro Muramatsu, Tomonori Kawasaki, Tsubasa Ishikawa, Shomei Ryozawa
    VideoGIE.2023; 8(4): 167.     CrossRef
  • Future therapeutic implications of new molecular mechanism of colorectal cancer
    Sen Lu, Cheng-You Jia, Jian-She Yang
    World Journal of Gastroenterology.2023; 29(16): 2359.     CrossRef
  • Iatrogenic colorectal perforation caused by a clip
    Hirotaka Oura, Yasuki Hatayama, Erika Nomura, Harutoshi Sugiyama, Daisuke Murakami, Makoto Arai, Takayoshi Nishino
    Endoscopy.2023; 55(S 01): E1091.     CrossRef
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Clinical Impact of Different Reconstruction Methods on Remnant Gastric Cancer at the Anastomotic Site after Distal Gastrectomy
Kei Matsumoto, Shinwa Tanaka, Takashi Toyonaga, Nobuaki Ikezawa, Mari Nishio, Masanao Uraoka, Tomoatsu Yoshihara, Hiroya Sakaguchi, Hirofumi Abe, Tetsuya Yoshizaki, Madoka Takao, Toshitatsu Takao, Yoshinori Morita, Hiroshi Yokozaki, Yuzo Kodama
Clin Endosc 2022;55(1):86-94.   Published online August 13, 2021
DOI: https://doi.org/10.5946/ce.2021.084
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: The anastomotic site after distal gastrectomy is the area most affected by duodenogastric reflux. Different reconstruction methods may affect the lesion characteristics and treatment outcomes of remnant gastric cancers at the anastomotic site. We retrospectively investigated the clinicopathologic and endoscopic submucosal dissection outcomes of remnant gastric cancers at the anastomotic site.
Methods
We recruited 34 consecutive patients who underwent endoscopic submucosal dissection for remnant gastric cancer at the anastomotic site after distal gastrectomy. Clinicopathology and treatment outcomes were compared between the Billroth II and non-Billroth II groups.
Results
The tumor size in the Billroth II group was significantly larger than that in the non-Billroth II group (22 vs. 19 mm; p=0.048). More severe gastritis was detected endoscopically in the Billroth II group (2 vs. 1.33; p=0.0075). Moreover, operation time was longer (238 vs. 121 min; p=0.004) and the frequency of bleeding episodes was higher (7.5 vs. 3.1; p=0.014) in the Billroth II group.
Conclusions
Compared to remnant gastric cancers in non-Billroth II patients, those in the Billroth II group had larger lesions with a background of severe remnant gastritis. Endoscopic submucosal dissection for remnant gastric cancers in Billroth II patients involved longer operative times and more frequent bleeding episodes than that in patients without Billroth II.
  • 4,605 View
  • 159 Download
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