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Advanced endoscopic resections in the treatment of malignant colorectal lesions: Are early oncological outcomes impacted?

Published:November 22, 2022DOI:https://doi.org/10.1016/j.amjsurg.2022.11.024

      Highlights

      • Advanced endoscopy do not have negative impact on early oncological outcomes of malignant colorectal lesions.
      • Intra-procedural perforation during ESD does not have negative impact on early oncological outcomes of malignant colorectal lesions.
      • Surveillance can be an option for selected patients with malignant colorectal lesions, even in the presence of poor prognostic features.

      Abstract

      Background

      Limited data exists on the impact of advanced endoscopic resections on early oncological outcomes of malignant colorectal lesions, especially in the presence of perforation.

      Methods

      Retrospective chart review of patients who underwent advanced endoscopic resections and had adenocarcinoma was performed. The primary endpoint was cancer recurrence.

      Results

      63 patients were included. Mean age was 64.6 years with 58.7% of the patients being male. Mean BMI was 30.2 kg/m2 12 patients underwent advanced endoscopic resections followed by surveillance, 5 patients had conversion to surgery due to intra-procedural perforation, and 5 patients due to incomplete resection. 41 patients underwent salvage surgery following a median of 5.4 weeks of initial endoscopic resection. Neither local nor distant recurrence was observed within a median follow-up of 21.2 months.

      Conclusion

      Advanced endoscopic procedures do not have negative impact on the early oncological outcomes of patients with malignant colorectal lesions, even in the presence of perforation.

      Keywords

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