Gastroenterology Department, General Hospital of Nikaia - Piraeus "Agios Panteleimon", Mantouvalou D.3, Nikaia, 18454, Athens, Greece.
Department of Gastroenterology and Hepatology, Kindai University, Osaka, Japan.
Tech Coloproctol. 2023 Dec;27(12):1393-1400. doi: 10.1007/s10151-023-02862-7. Epub 2023 Sep 29.
In the current era of screening colonoscopy and increasing incidence of early rectal cancer, interventional endoscopy moves toward resections in deeper planes than the submucosal layer. Several reports support the use of endoscopic intermuscular dissection (EID) instead of endoscopic submucosal dissection (ESD) for the removal of deeply invasive rectal submucosal cancers. The resection plane into the intermuscular space, the space between the longitudinal (external) and circular (internal) muscle layer, allows radical removal of rectal invasive submucosal cancers. Furthermore, the technique offers the potential for dissection of scarred and severe fibrotic lesions in the rectum by cutting deeper and performing a partial myectomy avoiding the narrow submucosal space. We present 23 cases of EIDs both for deeply invasive rectal cancers and benign rectal lesions. This is the first report in the literature of EID resections for malignant and benign disease, including cases of severely fibrotic rectal lesions.
在当前的结肠镜筛查和早期直肠癌发病率增加的时代，介入内镜的手术部位已深入到黏膜下层以外的层次。有几项研究报告支持使用内镜肌间分离术（EID）代替内镜黏膜下剥离术（ESD）来切除深度浸润性直肠黏膜下癌。该手术的切除平面位于肌间，即纵行（外）和环形（内）肌层之间的空间，可彻底切除直肠浸润性黏膜下癌。此外，该技术还可以通过更深的切割和部分肌切除术来分离直肠中瘢痕和严重纤维化病变，从而避免狭窄的黏膜下空间。我们报告了 23 例 EID 治疗深度浸润性直肠癌和良性直肠病变的病例。这是文献中首次报道 EID 用于治疗恶性和良性疾病的病例，包括严重纤维化的直肠病变。
