Clinical application of endoscopic submucosal dissection for superficially invasive squamous cell carcinoma/high-grade squamous intraepithelial lesion involving the canal anal.

IF 2.7 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
H-I Ng, B-H Chen, Y-M Zhang, W Zhang, Y Liu, G-Q Wang
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Abstract

Background: Superficially invasive squamous cell carcinoma (SISCC) and high-grade squamous intraepithelial lesions (HSIL) involving the anal canal are rare, and their surgical management involves local excision. Endoscopic submucosal dissection (ESD) has recently emerged as a promising treatment. This study aimed to evaluate the feasibility and safety of ESD for SISCC and HSIL in the anal canal.

Methods: All patients diagnosed with SISCC or HSIL in the anal canal who underwent ESD between November 2018 and May 2023 were included. Patient age, sex, pathology, human immunodeficiency virus (HIV) status, human papillomavirus (HPV) status, T stage, en bloc rate, and R0 resection rate were analyzed.

Results: Ten patients, including two men and eight women, with a median age of 61 (51-68) years were enrolled. All patients were HIV-negative, but five (50%) were HPV-positive. Pathological examination showed tumor stage of two patients as T2, one as T0 of SISCC, and seven as Tis of HSIL. The median specimen and tumor sizes were 24 (6-65) mm and 18 (6-55) mm, respectively. The en bloc and R0 resection rates were 100% and 80%, respectively. No severe complications occurred and no recurrence was observed at the follow-up (median follow-up period, 9 (1-35) months).

Conclusions: ESD is a reliable and minimally invasive procedure that enables more individualized treatment options for specific groups. As we were limited by the length of the observation period, the long-term performance of ESD for SISCC and HSIL involving the anal canal requires further investigation.

Abstract Image

内窥镜粘膜下剥离术治疗肛管浅表浸润性鳞状细胞癌/高级别鳞状上皮内病变的临床应用。
背景:累及肛管的表面浸润性鳞状细胞癌(SISCC)和高级别鳞状上皮内病变(HSIL)非常罕见,其手术治疗包括局部切除。最近,内镜粘膜下剥离术(ESD)成为一种很有前景的治疗方法。本研究旨在评估ESD治疗肛管SISCC和HSIL的可行性和安全性:纳入2018年11月至2023年5月期间接受ESD治疗的所有确诊为肛管SISCC或HSIL的患者。对患者的年龄、性别、病理、人类免疫缺陷病毒(HIV)状态、人类乳头瘤病毒(HPV)状态、T期、全切率、R0切除率进行分析:共纳入 10 名患者,包括 2 名男性和 8 名女性,中位年龄为 61(51-68)岁。所有患者均为 HIV 阴性,但有 5 人(50%)HPV 阳性。病理检查显示,2 名患者的肿瘤分期为 T2,1 名患者的 SISCC 分期为 T0,7 名患者的 HSIL 分期为 Tis。标本和肿瘤的中位尺寸分别为24(6-65)毫米和18(6-55)毫米。全切率和R0切除率分别为100%和80%。无严重并发症发生,随访中未发现复发(中位随访时间为9(1-35)个月):ESD是一种可靠的微创手术,可为特定人群提供更多个性化治疗方案。结论:ESD是一种可靠的微创手术,可为特定人群提供更多个体化治疗方案。由于我们的观察期有限,ESD治疗涉及肛管的SISCC和HSIL的长期效果还需进一步研究。
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来源期刊
Techniques in Coloproctology
Techniques in Coloproctology GASTROENTEROLOGY & HEPATOLOGY-SURGERY
CiteScore
5.30
自引率
9.10%
发文量
176
审稿时长
1 months
期刊介绍: Techniques in Coloproctology is an international journal fully devoted to diagnostic and operative procedures carried out in the management of colorectal diseases. Imaging, clinical physiology, laparoscopy, open abdominal surgery and proctoperineology are the main topics covered by the journal. Reviews, original articles, technical notes and short communications with many detailed illustrations render this publication indispensable for coloproctologists and related specialists. Both surgeons and gastroenterologists are represented on the distinguished Editorial Board, together with pathologists, radiologists and basic scientists from all over the world. The journal is strongly recommended to those who wish to be updated on recent developments in the field, and improve the standards of their work. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1965 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the Principles of Laboratory Animal Care (NIH publication no. 86-23 revised 1985) were followed as were applicable national laws (e.g. the current version of the German Law on the Protection of Animals). The Editor-in-Chief reserves the right to reject manuscripts that do not comply with the above-mentioned requirements. Authors will be held responsible for false statements or for failure to fulfill such requirements.
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