Endoscopy 2020; 52(S 01): S143
DOI: 10.1055/s-0040-1704440
ESGE Days 2020 ePoster Podium presentations
Thursday, April 23, 2020 11:00 – 11:30 ESD 2 ePoster Podium 7
© Georg Thieme Verlag KG Stuttgart · New York

FEASIBILITY, SAFETY AND EFFECTIVENESS OF ENDOSCOPIC SUBMUCOSAL DISSECTION OF GASTROINTESTINAL LESIONS IN OUTPATIENTS VS INPATIENTS

S Sferrazza
1   Gastroenterology and Endoscopy Unit, Santa Chiara Hospital, Trento, Italy
,
M Maida
2   Gastroenterology and Endoscopy Unit, S. Elia-Raimondi Hospital, Caltanissetta, Italy
,
M Jovani
3   Division of Gastroenterology and Hepatology, Johns Hopkins Hospital, Baltimore, U S A
,
F Vieceli
1   Gastroenterology and Endoscopy Unit, Santa Chiara Hospital, Trento, Italy
,
GD Pretis
1   Gastroenterology and Endoscopy Unit, Santa Chiara Hospital, Trento, Italy
,
R Maselli
4   Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Research Hospital, Milano, Italy
,
A Repici
4   Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Research Hospital, Milano, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

Also available at
 

Aims Endoscopic submucosal dissection (ESD) allows ‘en-bloc’ resection of superficial gastrointestinal neoplasms. Usually, ESDs are performed as inpatients. This study aimed to assess the feasibility, safety and efficacy of ESD in outpatients compared to inpatients.

Methods We retrospectively reviewed a prospective cohort of 83 consecutive patients undergoing a ESD at one Italian tertiary referral centre from August 2017 to October 2019.

Results Eighty-three patients with 83 lesions undergoing ESD were reviewed. Of these, 69% were located in the rectum and in the sigma, 4% in the right colon, 5% in the esophagus and 22% in the stomach. Overall, 70 (84.3%) were inpatients and 13 (15.7%) outpatients. Mean age was 69.5±13.0 and 67.4±12.8 years respectively (p=0.5). In both groups most lesions were lateral spreading tumors (58.6% vs 61.6%, p=0.8). Inpatient presented a larger mean lesion size of 36.8±15.0 vs 30.7±10.5 mm (p=0.09), and a higher prevalence of Kudo type IV lesions in 67.3 vs 50.0% (p=0.02). ESD was feasible in all cases. The median duration of procedures was higher in inpatients (112.3 vs 71.9 minutes; p=0.008). Complications occurred in 9/70 (13.2%) of inpatients vs 1/13 (7.7%) of outpatients (p=0.5). In the inpatient group there were six perforations treated endoscopically and three minor bleedings, whereas in the outpatient group there were three minor bleedings. All outpatients were observed for 8-10 hours and discharged the same day of procedure.

A R0 resection was achieved in 59/70 (84.3%) and 10/13 (76.9%) of patients, respectively. Both budding and angioinvasion were observed in 2 cases (1 in each group).

After a median follow-up of 8.4 months, recurrence was observed in 1/70 inpatients and in 0/13 outpatients and the only case of recurrence was successfully treated with EMR.

Conclusions Our experience confirmed that ESD is also feasible, effective and safe on an outpatient basis for selected and less complex gastrointestinal lesions.