Current status of colorectal endoscopic submucosal dissection in Japan and other Asian countries: progressing towards technical standardization

Dig Endosc. 2012 May:24 Suppl 1:67-72. doi: 10.1111/j.1443-1661.2012.01282.x.

Abstract

Aim: The primary purpose of this questionnaire survey study was to determine the current status of colorectal endoscopic submucosal dissection (ESD) in specialized Japanese referral centers before and after introduction of a government-approved advanced medical treatment system; and, secondly, to determine the current status of colorectal ESD in other Asian specialized referral centers.

Methods: A total of 1321 colorectal ESDs were performed in 11 institutions including two Asian centers outside Japan.

Results: Overall en-bloc resection, curative resection, R0 resection, perforation, delayed bleeding and emergency surgery rates were 95.4%, 89.1%, 87.2%, 2.9%, 2.5% and 0.2%, respectively. Similar clinical results were reported in the two Asian centers.

Conclusion: There were no significant differences with regards to clinical results between the two periods although the perforation rate decreased from 3.3% to 2.4%. In addition, colorectal ESD has become increasingly standardized technically at specialized referral centers not only in Japan, but several other Asian referral institutions as well.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Colorectal Neoplasms / pathology
  • Colorectal Neoplasms / surgery*
  • Dissection / methods*
  • Dissection / statistics & numerical data
  • Endoscopy, Gastrointestinal / adverse effects
  • Endoscopy, Gastrointestinal / methods*
  • Endoscopy, Gastrointestinal / standards
  • Female
  • Health Care Surveys
  • Humans
  • Intestinal Mucosa / surgery
  • Intraoperative Complications / epidemiology
  • Japan
  • Male
  • Middle Aged
  • Surveys and Questionnaires
  • Young Adult