Transanal endoscopic microsurgical submucosal dissection for recurrent rectal adenomas

• Verfasst von: Kouladouros, Konstantinos [VerfasserIn]
• Verfasst von: Baral, Jörg [VerfasserIn]
• Titel: Transanal endoscopic microsurgical submucosal dissection for recurrent rectal adenomas
• Verf.angabe: Konstantinos Kouladouros, Jörg Baral
• E-Jahr: 2023
• Jahr: January 31 2023
• Umfang: 7 S.
• Fussnoten: Online veröffentlicht: 24. Februar 2022 ; Gesehen am 01.07.2024
• Titel Quelle: Enthalten in: Digestive diseases
• Ort Quelle: Basel : Karger, 1983
• Jahr Quelle: 2023
• Band/Heft Quelle: 41(2023), 1 vom: Jan., Seite 89-95
• ISSN Quelle: 1421-9875
• DOI: doi:10.1159/000523672
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1892812835

Abstract

Background: The local resection of recurrent rectal adenomas is a technically challenging task associated with increased local recurrence rate. Transanal endoscopic microsurgical submucosal dissection (TEM-ESD) uses traction to better expose the fibrotic submucosal layer, and therefore, is a valuable alternative for the treatment of such lesions. The aim of our study was to assess the feasibility and outcomes of TEM-ESD for the resection of recurrent rectal adenomas. Methods: We retrospectively analysed all TEM-ESD procedures performed in the Karlsruhe Municipal Hospital between 2012 and 2021 and isolated all cases of recurrent adenomas. Subsequently, we matched these cases 1:1 to TEM-ESD cases for primary rectal adenomas according to the size, localization, and histological type of the lesions and compared the outcomes between the two groups. Results: We identified 19 cases matching our criteria. The median diameter of the lesions was 25 mm and the median operating time 39 min. Macroscopic en bloc resection was achieved in 100% of the cases and histological complete en bloc resection in 78.9%. There was 1 case of conservatively treated postoperative bleeding. After a median follow-up period of 36 months, there was one local recurrence. After comparing those findings to the outcomes of TEM-ESD for primary rectal lesions, we found no significant differences on total operating time, complete en bloc resection rates, adverse events, and local recurrence. Conclusion: TEM-ESD is a feasible therapeutic option for the resection of recurrent rectal adenomas, offering short operating times as well as high en bloc resection and low recurrence rates.