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Published in: Surgical Endoscopy 9/2017

Open Access 01-09-2017

Colorectal ESD in day surgery

Authors: Tomohiko Ohya, Richard Marsk, Klas Pekkari

Published in: Surgical Endoscopy | Issue 9/2017

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Abstract

Background

Colorectal endoscopic submucosal dissection (ESD) was developed in Japan and is growing in popularity in Europe. Patients undergoing a colorectal ESD procedure in Japan are hospitalized for several days. In this study, we investigated the feasibility of colorectal ESD as an outpatient procedure in a European setting.

Methods

A prospective cohort of all patients undergoing colorectal ESD at Danderyds Hospital, Stockholm, Sweden from April 2014 to December 2015 were studied. Data on patient demographics, procedural outcome and 30-day readmissions were studied. Data are presented as median (range), mean ± SD or true numbers as appropriate.

Results

A total of 182 patients underwent a colorectal ESD during the study period. Of the 182 these, 11 were scheduled for an in-hospital procedure and of 171 patients scheduled for a day-procedure and 15 were admitted for observation. The remaining 156 patients were discharged after 2–4 h of observation and comprise the study cohort. Mean age was 69 years. Median lesion size was 28 (10–120) mm, and median resection time was 65 (10–360) min. Lesions were located as follows: anal canal 1 (0.6%), rectum 52 (33.3%), sigmoid 17 (10.9%), descending 3 (1.9%), transverse 24 (15.4%), ascending 29 (18.6%), and cecum 30 (19.2%). Eight (5.1%) of the 156 day surgery patients returned for medical attention during the postoperative 30-day period. Three of them were admitted for in-hospital observation. None of the day surgery patients required any surgical intervention.

Conclusion

Uncomplicated colorectal ESD can safely be carried out in a day surgery setting.
Literature
1.
go back to reference Cancer incidence in Sweden 2010 (2011) Socialstyrelsen Cancer incidence in Sweden 2010 (2011) Socialstyrelsen
2.
3.
go back to reference Manser CN, Bachmann LM, Brunner J, Hunold F, Bauerfeind P, Marbet UA (2012) Colonoscopy screening markedly reduces the occurrence of colon carcinomas and carcinoma-related death: a closed cohort study. Gastrointest Endosc 76(1):110–117CrossRefPubMed Manser CN, Bachmann LM, Brunner J, Hunold F, Bauerfeind P, Marbet UA (2012) Colonoscopy screening markedly reduces the occurrence of colon carcinomas and carcinoma-related death: a closed cohort study. Gastrointest Endosc 76(1):110–117CrossRefPubMed
4.
go back to reference Winawer SJ, Zauber AG, Ho MN, O’Brien MJ, Gottlieb LS, Sternberg SS, Waye JD, Schapiro M, Bond JH, Panish JF et al (1993) Prevention of colorectal cancer by colonoscopic polypectomy. The National Polyp Study Workgroup. N Engl J Med 329(27):1977–1981CrossRefPubMed Winawer SJ, Zauber AG, Ho MN, O’Brien MJ, Gottlieb LS, Sternberg SS, Waye JD, Schapiro M, Bond JH, Panish JF et al (1993) Prevention of colorectal cancer by colonoscopic polypectomy. The National Polyp Study Workgroup. N Engl J Med 329(27):1977–1981CrossRefPubMed
5.
go back to reference Zauber AG, Winawer SJ, O’Brien MJ, Lansdorp-Vogelaar I, van Ballegooijen M, Hankey BF, Shi W, Bond JH, Schapiro M, Panish JF, Stewart ET, Waye JD (2012) Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths. N Engl J Med 366(8):687–696CrossRefPubMedPubMedCentral Zauber AG, Winawer SJ, O’Brien MJ, Lansdorp-Vogelaar I, van Ballegooijen M, Hankey BF, Shi W, Bond JH, Schapiro M, Panish JF, Stewart ET, Waye JD (2012) Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths. N Engl J Med 366(8):687–696CrossRefPubMedPubMedCentral
6.
go back to reference Arezzo A, Passera R, Marchese N, Galloro G, Manta R, Cirocchi R (2016) Systematic review and meta-analysis of endoscopic submucosal dissection vs endoscopic mucosal resection for colorectal lesions. United Eur Gastroenterol J 4(1):18–29CrossRef Arezzo A, Passera R, Marchese N, Galloro G, Manta R, Cirocchi R (2016) Systematic review and meta-analysis of endoscopic submucosal dissection vs endoscopic mucosal resection for colorectal lesions. United Eur Gastroenterol J 4(1):18–29CrossRef
7.
go back to reference Tajika M, Niwa Y, Bhatia V, Kondo S, Tanaka T, Mizuno N, Hara K, Hijioka S, Imaoka H, Ogura T, Haba S, Yamao K (2011) Comparison of endoscopic submucosal dissection and endoscopic mucosal resection for large colorectal tumors. Eur J Gastroenterol Hepatol 23(11):1042–1049PubMed Tajika M, Niwa Y, Bhatia V, Kondo S, Tanaka T, Mizuno N, Hara K, Hijioka S, Imaoka H, Ogura T, Haba S, Yamao K (2011) Comparison of endoscopic submucosal dissection and endoscopic mucosal resection for large colorectal tumors. Eur J Gastroenterol Hepatol 23(11):1042–1049PubMed
8.
go back to reference Lee EJ, Lee JB, Lee SH, Youk EG (2012) Endoscopic treatment of large colorectal tumors: comparison of endoscopic mucosal resection, endoscopic mucosal resection-precutting, and endoscopic submucosal dissection. Surg Endosc 26(8):2220–2230CrossRefPubMed Lee EJ, Lee JB, Lee SH, Youk EG (2012) Endoscopic treatment of large colorectal tumors: comparison of endoscopic mucosal resection, endoscopic mucosal resection-precutting, and endoscopic submucosal dissection. Surg Endosc 26(8):2220–2230CrossRefPubMed
9.
go back to reference Terasaki M, Tanaka S, Oka S, Nakadoi K, Takata S, Kanao H, Yoshida S, Chayama K (2012) Clinical outcomes of endoscopic submucosal dissection and endoscopic mucosal resection for laterally spreading tumors larger than 20 mm. J Gastroenterol Hepatol 27(4):734–740CrossRefPubMed Terasaki M, Tanaka S, Oka S, Nakadoi K, Takata S, Kanao H, Yoshida S, Chayama K (2012) Clinical outcomes of endoscopic submucosal dissection and endoscopic mucosal resection for laterally spreading tumors larger than 20 mm. J Gastroenterol Hepatol 27(4):734–740CrossRefPubMed
10.
go back to reference Wang J, Zhang XH, Ge J, Yang CM, Liu JY, Zhao SL (2014) Endoscopic submucosal dissection vs endoscopic mucosal resection for colorectal tumors: a meta-analysis. World J Gastroenterol 20(25):8282–8287CrossRefPubMedPubMedCentral Wang J, Zhang XH, Ge J, Yang CM, Liu JY, Zhao SL (2014) Endoscopic submucosal dissection vs endoscopic mucosal resection for colorectal tumors: a meta-analysis. World J Gastroenterol 20(25):8282–8287CrossRefPubMedPubMedCentral
11.
go back to reference Fujiya M, Tanaka K, Dokoshi T, Tominaga M, Ueno N, Inaba Y, Ito T, Moriichi K, Kohgo Y (2015) Efficacy and adverse events of EMR and endoscopic submucosal dissection for the treatment of colon neoplasms: a meta-analysis of studies comparing EMR and endoscopic submucosal dissection. Gastrointest Endosc 81(3):583–595CrossRefPubMed Fujiya M, Tanaka K, Dokoshi T, Tominaga M, Ueno N, Inaba Y, Ito T, Moriichi K, Kohgo Y (2015) Efficacy and adverse events of EMR and endoscopic submucosal dissection for the treatment of colon neoplasms: a meta-analysis of studies comparing EMR and endoscopic submucosal dissection. Gastrointest Endosc 81(3):583–595CrossRefPubMed
12.
go back to reference Aoki T, Nakajima T, Saito Y, Matsuda T, Sakamoto T, Itoi T, Khiyar Y, Moriyasu F (2012) Assessment of the validity of the clinical pathway for colon endoscopic submucosal dissection. World J Gastroenterol 18(28):3721–3726CrossRefPubMedPubMedCentral Aoki T, Nakajima T, Saito Y, Matsuda T, Sakamoto T, Itoi T, Khiyar Y, Moriyasu F (2012) Assessment of the validity of the clinical pathway for colon endoscopic submucosal dissection. World J Gastroenterol 18(28):3721–3726CrossRefPubMedPubMedCentral
13.
go back to reference Tomiki Y, Kawai M, Takehara K, Tashiro Y, Munakata S, Kure K, Ishiyama S, Sugimoto K, Kamiyama H, Takahashi M, Sakamoto K (2015) Clinical pathway to discharge 3 days after colorectal endoscopic submucosal dissection. Dig Endosc 27(6):679–686CrossRefPubMed Tomiki Y, Kawai M, Takehara K, Tashiro Y, Munakata S, Kure K, Ishiyama S, Sugimoto K, Kamiyama H, Takahashi M, Sakamoto K (2015) Clinical pathway to discharge 3 days after colorectal endoscopic submucosal dissection. Dig Endosc 27(6):679–686CrossRefPubMed
14.
go back to reference Bialek A, Pertkiewicz J, Karpinska K, Marlicz W, Bielicki D, Starzynska T (2014) Treatment of large colorectal neoplasms by endoscopic submucosal dissection: a European single-center study. Eur J Gastroenterol Hepatol 26(8):607–615PubMed Bialek A, Pertkiewicz J, Karpinska K, Marlicz W, Bielicki D, Starzynska T (2014) Treatment of large colorectal neoplasms by endoscopic submucosal dissection: a European single-center study. Eur J Gastroenterol Hepatol 26(8):607–615PubMed
15.
go back to reference Tanaka S, Kashida H, Saito Y, Yahagi N, Yamano H, Saito S, Hisabe T, Yao T, Watanabe M, Yoshida M, Kudo SE, Tsuruta O, Sugihara K, Watanabe T, Saitoh Y, Igarashi M, Toyonaga T, Ajioka Y, Ichinose M, Matsui T, Sugita A, Sugano K, Fujimoto K, Tajiri H (2015) JGES guidelines for colorectal endoscopic submucosal dissection/endoscopic mucosal resection. Dig Endosc 27(4):417–434CrossRefPubMed Tanaka S, Kashida H, Saito Y, Yahagi N, Yamano H, Saito S, Hisabe T, Yao T, Watanabe M, Yoshida M, Kudo SE, Tsuruta O, Sugihara K, Watanabe T, Saitoh Y, Igarashi M, Toyonaga T, Ajioka Y, Ichinose M, Matsui T, Sugita A, Sugano K, Fujimoto K, Tajiri H (2015) JGES guidelines for colorectal endoscopic submucosal dissection/endoscopic mucosal resection. Dig Endosc 27(4):417–434CrossRefPubMed
16.
go back to reference DRG-statistik 2014 (2015) En beskrivning av vårdstatistik i Sverige. Socialstyrelsen DRG-statistik 2014 (2015) En beskrivning av vårdstatistik i Sverige. Socialstyrelsen
17.
go back to reference Gustafsson UO, Oppelstrup H, Thorell A, Nygren J, Ljungqvist O (2016) Adherence to the ERAS protocol is associated with 5-year survival after colorectal cancer surgery: a Retrospective Cohort Study. World J Surg. doi:10.1007/s00268-016-3460-y Gustafsson UO, Oppelstrup H, Thorell A, Nygren J, Ljungqvist O (2016) Adherence to the ERAS protocol is associated with 5-year survival after colorectal cancer surgery: a Retrospective Cohort Study. World J Surg. doi:10.​1007/​s00268-016-3460-y
18.
go back to reference Gustafsson UO, Scott MJ, Schwenk W, Demartines N, Roulin D, Francis N, McNaught CE, MacFie J, Liberman AS, Soop M, Hill A, Kennedy RH, Lobo DN, Fearon K, Ljungqvist O (2012) Guidelines for perioperative care in elective colonic surgery: enhanced recovery after surgery (ERAS(R)) society recommendations. Clin Nutr 31(6):783–800CrossRefPubMed Gustafsson UO, Scott MJ, Schwenk W, Demartines N, Roulin D, Francis N, McNaught CE, MacFie J, Liberman AS, Soop M, Hill A, Kennedy RH, Lobo DN, Fearon K, Ljungqvist O (2012) Guidelines for perioperative care in elective colonic surgery: enhanced recovery after surgery (ERAS(R)) society recommendations. Clin Nutr 31(6):783–800CrossRefPubMed
19.
go back to reference Gustafsson UO, Scott MJ, Schwenk W, Demartines N, Roulin D, Francis N, McNaught CE, Macfie J, Liberman AS, Soop M, Hill A, Kennedy RH, Lobo DN, Fearon K, Ljungqvist O, Enhanced Recovery After Surgery Society, for Perioperative Care, European Society for Clinical Nutrition, Metabolism, International Association for Surgical, Metabolism Nutrition (2013) Guidelines for perioperative care in elective colonic surgery: enhanced Recovery After Surgery (ERAS((R))) Society recommendations. World J Surg 37(2):259–284CrossRefPubMed Gustafsson UO, Scott MJ, Schwenk W, Demartines N, Roulin D, Francis N, McNaught CE, Macfie J, Liberman AS, Soop M, Hill A, Kennedy RH, Lobo DN, Fearon K, Ljungqvist O, Enhanced Recovery After Surgery Society, for Perioperative Care, European Society for Clinical Nutrition, Metabolism, International Association for Surgical, Metabolism Nutrition (2013) Guidelines for perioperative care in elective colonic surgery: enhanced Recovery After Surgery (ERAS((R))) Society recommendations. World J Surg 37(2):259–284CrossRefPubMed
20.
go back to reference Saito Y, Uraoka T, Yamaguchi Y, Hotta K, Sakamoto N, Ikematsu H, Fukuzawa M, Kobayashi N, Nasu J, Michida T, Yoshida S, Ikehara H, Otake Y, Nakajima T, Matsuda T, Saito D (2010) A prospective, multicenter study of 1111 colorectal endoscopic submucosal dissections (with video). Gastrointest Endosc 72(6):1217–1225CrossRefPubMed Saito Y, Uraoka T, Yamaguchi Y, Hotta K, Sakamoto N, Ikematsu H, Fukuzawa M, Kobayashi N, Nasu J, Michida T, Yoshida S, Ikehara H, Otake Y, Nakajima T, Matsuda T, Saito D (2010) A prospective, multicenter study of 1111 colorectal endoscopic submucosal dissections (with video). Gastrointest Endosc 72(6):1217–1225CrossRefPubMed
21.
go back to reference Suzuki S, Chino A, Kishihara T, Uragami N, Tamegai Y, Suganuma T, Fujisaki J, Matsuura M, Itoi T, Gotoda T, Igarashi M, Moriyasu F (2014) Risk factors for bleeding after endoscopic submucosal dissection of colorectal neoplasms. World J Gastroenterol 20(7):1839–1845CrossRefPubMedPubMedCentral Suzuki S, Chino A, Kishihara T, Uragami N, Tamegai Y, Suganuma T, Fujisaki J, Matsuura M, Itoi T, Gotoda T, Igarashi M, Moriyasu F (2014) Risk factors for bleeding after endoscopic submucosal dissection of colorectal neoplasms. World J Gastroenterol 20(7):1839–1845CrossRefPubMedPubMedCentral
22.
go back to reference Hirasawa K, Sato C, Makazu M, Kaneko H, Kobayashi R, Kokawa A, Maeda S (2015) Coagulation syndrome: delayed perforation after colorectal endoscopic treatments. World J Gastrointest Endosc 7(12):1055–1061CrossRefPubMedPubMedCentral Hirasawa K, Sato C, Makazu M, Kaneko H, Kobayashi R, Kokawa A, Maeda S (2015) Coagulation syndrome: delayed perforation after colorectal endoscopic treatments. World J Gastrointest Endosc 7(12):1055–1061CrossRefPubMedPubMedCentral
Metadata
Title
Colorectal ESD in day surgery
Authors
Tomohiko Ohya
Richard Marsk
Klas Pekkari
Publication date
01-09-2017
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 9/2017
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-016-5407-7

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