Medicina Aparato Digestivo. Unidad de Endoscopia, Hospital Universitario 12 de Octubre, España.
Medicina Aparato Digestivo. Unidad de Endoscopia, Hospital Universitario 12 de Octubre.
Rev Esp Enferm Dig. 2020 Mar;112(3):172-177. doi: 10.17235/reed.2020.6268/2019.
ESD in the colon is an increasingly important technique in Western countries. There are few studies that include long term follow-up.
to analyze the long term recurrence free survival rate after ESD and to compare recurrence rates according to different variables.
this was a prospective observational study of patients with a planned ESD from September 2008 to December 2015. When it was not possible to achieve an ESD, hybrid ESD was performed, either en bloc or piecemeal. Kaplan-Meier survival curves were used to assess the five year local recurrence free survival rate and the recurrence rate. The results were compared according to different factors.
of the 89 patients scheduled for ESD who were initially enrolled in the study, 69 were finally included for follow-up. ESD was performed in 31 (45%) patients, KAR in eleven (16%) and pKAR in 27 (39%). The median follow-up was 27 months (range 6-60). The five year disease free survival rate was 81%. The average number of endoscopies needed to eliminate recurrence was two (range 2-7) and no patient required surgery for this reason. The recurrence rate was significantly higher in piecemeal resections vs en bloc resections (27% vs 15%, p = 0.036) and R1 resections vs R0 resections (26% vs 0%, p = 0.034). The presence of affected or unknown lateral margins in en bloc resections without other poor prognosis factors had higher recurrence rates but the difference was not statistically significant (28% vs 0%, p = 0.09).
in our study, the five year disease free survival rate was 81% and no patient required surgery during follow-up. Piecemeal and R1 resections had significantly higher recurrence rates, as well as LM involvement, although this was not statistically significant.
ESD 在结肠中是西方国家中一种越来越重要的技术。很少有研究包括长期随访。
分析 ESD 后的无复发生存率，并根据不同变量比较复发率。
这是一项前瞻性观察性研究，纳入了 2008 年 9 月至 2015 年 12 月计划进行 ESD 的患者。当无法进行 ESD 时，行杂交 ESD，整块或分片。采用 Kaplan-Meier 生存曲线评估 5 年局部无复发生存率和复发率。根据不同因素比较结果。
最初纳入研究的 89 例计划行 ESD 的患者中，最终有 69 例纳入随访。31 例（45%）患者行 ESD，11 例（16%）行 KAR，27 例（39%）行 pKAR。中位随访时间为 27 个月（6-60 个月）。5 年无病生存率为 81%。消除复发所需的平均内镜检查次数为 2 次（2-7 次），无患者因此需要手术。分片切除的复发率明显高于整块切除（27%比 15%，p = 0.036），R1 切除的复发率明显高于 R0 切除（26%比 0%，p = 0.034）。整块切除时存在受影响或未知的侧向边缘且无其他不良预后因素的患者复发率较高，但差异无统计学意义（28%比 0%，p = 0.09）。
在我们的研究中，5 年无病生存率为 81%，随访期间无患者需要手术。分片和 R1 切除的复发率明显较高，且侧向边缘受累，尽管这无统计学意义。
