Endoscopic submucosal dissection for the treatment of gastrointestinal neoplasia in a tertiary-care center in Mexico.

Cirugia y cirujanos Pub Date : 2024-01-01 DOI:10.24875/CIRU.23000052

Óscar V Hernández-Mondragón, Luis F García-Contreras

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Abstract

Objective: The aim of this study was to evaluate the experience of using endoscopic submucosal dissection (ESD), a technique considered as first-line of treatment, for the management of early neoplastic lesions (ENL), and subepithelial lesions (SEL) < 4 cms in size, in a tertiary-care, high-volume medical center in Mexico.

Method: Patients > 18 years-old, candidates to ESD with ENL and SMT, between January 2008 and October 2022 were included.

Results: ESD was performed in 246 patients (137 ENL and 109 SMT), 52.2% gastric, 23.1% colonic, 19.5% esophageal and 5.2% in duodenum. Benign/premalignant were 74.4%, and 25.6% malignant, being the SMT the most frequent (44.3%) and gastrointestinal stromal tumor. En-bloc resection, R0, and curative resection rates were 97.2%, 94.5%, and 85.8%, respectively. The most common adverse event was transprocedural bleeding (18.3%) followed by perforation (6.9%), both endoscopically treated without mortality. Recurrence was presented in 9.44% at 177 months of follow-up.

Conclusions: ESD is a safe and effective endoscopic surgical option of treatment for ENL and SMT in Mexican population when performed in experienced centers.

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墨西哥一家三级医疗中心采用内镜粘膜下剥离术治疗胃肠道肿瘤。

研究目的本研究旨在评估墨西哥一家三级高容量医疗中心使用内镜黏膜下剥离术（ESD）治疗早期肿瘤病变（ENL）和上皮下病变（SEL）（小于4厘米）的经验，ESD是一种被视为一线治疗的技术：方法：纳入2008年1月至2022年10月期间年龄大于18岁、患有ENL和SMT的ESD候选患者：246名患者（137名ENL患者和109名SMT患者）接受了ESD治疗，其中52.2%为胃癌，23.1%为结肠癌，19.5%为食管癌，5.2%为十二指肠癌。良性/前恶性占74.4%，恶性占25.6%，其中以SMT和胃肠道间质瘤最为常见（44.3%）。原位切除率、R0率和治愈率分别为97.2%、94.5%和85.8%。最常见的不良反应是经手术出血（18.3%），其次是穿孔（6.9%），这两种情况均在内镜下处理，无死亡病例。在177个月的随访中，9.44%的患者出现复发：在经验丰富的医疗中心进行ESD手术，是治疗墨西哥ENL和SMT的一种安全有效的内镜手术选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Cirugia y cirujanos

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