Korean J Gastrointest Endosc > Volume 42(4); 2011 > Article
Korean Journal of Gastrointestinal Endoscopy 2011;42(4): 222-227.
직장-구불 결장부 거대 표재성 종양의 내시경 점막하 박리술 치료 성적
고려대학교 의과대학 구로병원 소화기내과학교실
Treatment Outcomes after Endoscopic Submucosal Dissection of Large Superficial Rectosigmoid Colon Tumors
Jin-Sung Koh, M.D., Jong-Jae Park, M.D., Wonho Jung, M.D., Joon Young Lee, M.D., Sang-Ah Lim, M.D., Minjung Kwon, M.D., Hyejin Noh, M.D., Moon Kyung Joo, M.D., Beom Jae Lee, M.D., Ji Hoon Kim, M.D., Jong Eun Yeon, M.D., Jae Seon Kim, M.D., Kwan Soo Byun,
Division of Gastroenterology, Department of Internal Medicine, Guro Hospital, Korea University College of Medicine, Seoul, Korea

Endoscopic submucosal dissection (ESD) of a colorectal tumor is technically difficult. This study aimed to analyze the clinical outcomes of superficial large rectosigmoid tumors after ESD.
Medical records of 15 patients with large rectosigmoid tumors (more than 30 mm), in which ESD performed, were reviewed retrospectively.
The mean tumor size was 42.5±14.3 mm (range, 30∼78 mm). A histological examination revealed a well-differentiated adenocarcinoma in five cases (33.3%), adenoma with high-grade dysplasia in six cases (40%), and low-grade dysplasia in four cases (26.7%). The mean procedural time was 90.5±60.7 min (range, 22∼246 min). The en bloc resection rate was 86.7%, and the complete resection rate 100%. The lateral resection margin was positive in four cases (26.6%), but no cases with a positive vertical margin were observed. Bleeding occurred in three cases (20%), and all were treated successfully using endoscopic measures. Perforations occurred in three cases (20%); two cases were treated by clipping and the other by a laparotomy.
ESD is a treatment option for superficial large rectosigmoid tumors. Further studies with larger cases and a longer term follow-up are needed to establish the efficacy and safety of ESD for colorectal tumors. (Korean J Gastrointest Endosc 2011;42:222-227)
Key Words: Endoscopic submucosal dissection, Large superficial tumor, Rectosigmoid colon, Outcomes
주요어: 내시경 점막하 박리술, 표재성 거대 종양, 직장-구불 결장, 성적
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