Endoscopy 2022; 54(S 01): S127
DOI: 10.1055/s-0042-1744893
Abstracts | ESGE Days 2022
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OUTCOMES AFTER COLORECTAL ESD LEARNING WITH IN-ROOM “GUEST-EXPERT”. FEASIBILITY AND RESULTS OF A DOUBLE-OPERATOR ESD REGIONAL CENTRUM IN SOUTHEAST SWEDEN

G. Katinios
1   Linköping University Hospital, Department of Gastroenterology and Hepatology, Linköping, Sweden
,
Y. Minato
2   NTT Medical Center Tokyo, Tokyo, Japan
,
M. Shafazand
3   Sahlgrenska University Hospital, Internal Medicine and Gastroenterology Department, Gothenburg, Sweden
,
S. Yamamoto
4   National Hospital Organization Osaka National Hospital, Department of Gastroenterology and Hepatology, Osaka, Japan
,
O. Bednarska
1   Linköping University Hospital, Department of Gastroenterology and Hepatology, Linköping, Sweden
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    Aims Colorectal ESD is a technically demanding procedure with a steep learning curve. Aim of this study is to evaluate the feasibility and outcomes of colorectal ESD after learning with a “guest-expert” in the room.

    Methods Two experienced endoscopists started practicing colorectal ESD after observing colorectal ESDs, attending ESD workshops and practical training on animal models. Between February-2018 and April-2019, three ESD experts, with experience of more than 200 colorectal ESD each, were invited from other hospitals for 13 procedures in total during the initiation of ESD practice. The following ESD procedures, done independently by two endoscopists, were evaluated.

    Results A total of 87 colorectal ESD procedures were completed from April-2019 until November-2021. 82%(n=71) were in rectum, and 18%(n=16) in other parts of the colon. 46%(n=40) were done with both operators simultaneously. Mean polyp size was 47,6±18,6mm, (20,6±15,8cm2). 79%(n=69) of procedures were completed with en-bloc resection and 21%(n=18) were converted to piecemeal resection because of technical difficulties(n=16) or invasive cancer(n=2). R0 resection was achieved in 79%(n=54) of en-bloc resections. No polyp relapse was observed in following controls until November-2021 in en-bloc resections(n=40). Periprocedural perforation occurred in 22%(n=19), 95%(n=18) treated conservatively (median hospital stay:1 day, range:0-3) and 5%(n=1) with explorative laparotomy. Post-polypectomy bleeding observed in 5%(n=4) and post-polypectomy syndrome in 3%(n=3). 3/10(30%) of diagnosed adenocarcinomas were curatively treated. Mean resection speed (time) for the last 25 cases was 10,6±6,4 cm2/h (174±97min).

    Conclusions Colorectal ESD learning with in-room “guest-expert” may be a feasible ESD learning method for a double-operator ESD regional centrum.


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    Publication History

    Article published online:
    14 April 2022

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