Outcomes of endoscopic sub-mucosal dissection in laterally spreading colorectal polyps: A tertiary care centre experience from India

• Published in: Indian journal of gastroenterology 2024-10, Vol.43 (5), p.1012-1020
• Main Authors: Nabi, Zaheer, Chaithanya, Manchu, Inavolu, Pradev, Ramchandani, Mohan, Reddy, Palle Manohar, Sayyed, Mahiboob, Basha, Jahangeer, Pal, Partha, Sekharan, Anuradha, Goud, Rajesh, Reddy, Praveen, Jagtap, Nitin, Kotla, Rama, Kalpala, Rakesh, Darisetty, Santhosh, Lakhtakia, Sundeep, Rao, Guduru Venkat, Tandan, Manu, Gupta, Rajesh, Devarasetti, Rangarao, Rebala, Pradeep, Shetty, Mahesh, Reddy, D. Nageshwar
• Format: Article
• Language: English
• Subjects: Adenomatous Polyps - pathology; Adenomatous Polyps - surgery; Aged; Colonic Polyps - pathology; Colonic Polyps - surgery; Colonoscopy - methods; Dissection - methods; Endoscopic Mucosal Resection - methods; Female; Gastroenterology; Hepatology; Humans; India; Intestinal Mucosa - pathology; Intestinal Mucosa - surgery; Male; Medicine; Medicine & Public Health; Middle Aged; Original Article; Retrospective Studies; Tertiary Care Centers; Treatment Outcome
• ISSN: 0254-8860; 0975-0711; 0975-0711
• DOI: 10.1007/s12664-024-01635-w

Background Endoscopic sub-mucosal dissection (ESD) is an established endoscopic modality for the management of colorectal polyps. However, there are no studies regarding the outcomes of ESD from India. In this study, we aimed at evaluating the outcomes of ESD in patients with adenomatous polyps in the colon and rectum. Methods Data of consecutive patients who underwent ESD for colorectal polyps from 2018 to 2021 were analyzed, retrospectively. The primary outcome of the study was the technical success of ESD. The secondary outcomes included the rate of histologically complete resection (R0), adverse events and recurrence. Results Seventy patients (63.5 years, 60% males) underwent ESD for polyps in colon and rectum. A majority were located in rectum (80%) and sigmoid colon (15.7%). Narrow band classification of the polyps was Japanese Narrow Band Imaging Expert Team (JNET)-2a in 50 (71.4%) and JNET-2b in 13 (18.6%) patients. ESD was technically successful in 64 (91.4%) patients using conventional technique (72.8%) and pocket or tunnelling technique (18.6%). There were no major adverse events. Histologically RO was achieved in 58 (82.8%) patients and deep sub-mucosal invasion was noted in 12 patients. At a median follow-up of 19 (interquartile range [IQR] 15–27) months, recurrence was noticed in four (5.7%) patients all of which could be managed endoscopically. Conclusion ESD, performed at a tertiary care centre in India, yields high rates of technical success and histologically R0, with a relatively low incidence of adverse events and recurrences. Graphical Abstract