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Endoscopy 2024; 56(10): 790-796
DOI: 10.1055/a-2316-4910
Innovations and brief communications

Traction-assisted endoscopic submucosal dissection for resection of ileocecal valve neoplasia: a French retrospective multicenter case series

Clara Yzet
1   Endoscopy and Gastroenterology Unit, Department of gastroenterology, CHU Amiens Picardie, Amiens, France
,
Timothée Wallenhorst
2   Endoscopy and Gastroenterology Unit, Pontchaillou University Hospital, Rennes, France
,
Jérémie Jacques
3   Department of Endoscopy and Gastroenterology, Dupuytren University Hospital, Limoges, France
,
Mariana Figueiredo Ferreira
4   Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Erasme University Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium
,
Jérôme Rivory
5   Endoscopy and Gastroenterology Unit, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
,
Florian Rostain
5   Endoscopy and Gastroenterology Unit, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
,
Louis-Jean Masgnaux
5   Endoscopy and Gastroenterology Unit, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
,
Jean Grimaldi
5   Endoscopy and Gastroenterology Unit, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
,
Romain Legros
3   Department of Endoscopy and Gastroenterology, Dupuytren University Hospital, Limoges, France
,
Pierre Lafeuille 
5   Endoscopy and Gastroenterology Unit, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
,
Jérémie Albouys
3   Department of Endoscopy and Gastroenterology, Dupuytren University Hospital, Limoges, France
,
Fabien Subtil
6   Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Université de Lyon, Université Claude Bernard Lyon 1, CNRS, Villeurbanne, France
,
Marion Schaefer 
7   Department of Endoscopy and Gastroenterology, Centre Hospitalier Universitaire de Nancy – Hôpitaux de Brabois, Nancy, France
,
Mathieu Pioche
5   Endoscopy and Gastroenterology Unit, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
› Author Affiliations Clinical Trial: Registration number (trial ID): NCT04592003, Trial registry: ClinicalTrials.gov, Type of Study: prospective, multicenter observational cohort
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Author commentary on Clara Yzet et al.Endoscopy 2024; 56(10): v23-v23
DOI: 10.1055/a-2343-1538

Abstract

Background The ileocecal valve (ICV) is considered to be one of the most difficult locations for endoscopic submucosal dissection (ESD). The objective of this study was to evaluate the efficacy and safety of traction-assisted ESD in this situation.

Methods All patients who underwent traction-assisted ESD for an ICV lesion at three centers were identified from a prospective ESD database. En bloc and R0 rates were evaluated. Factors associated with non-R0 resection were explored.

Results 106 patients with an ICV lesion were included. The median lesion size was 50 mm (interquartile range 38–60) and 58.5% (62/106) invaded the terminal ileum. The en bloc and R0 resection rates were 94.3% and 76.4%, respectively. Factors associated with non-R0 resection were lesions covering ≥75% of the ICV (odds ratio [OR] 0.21. 95%CI 0.06–0.76; P=0.02), and involving the anal lip (OR 0.36, 95%CI 0.13–0.99; P=0.04) or more than two sites on the ICV (OR 0.27, 95%CI 0.07–0.99; P=0.03).

Conclusion Traction-assisted ESD for treatment of ICV lesions was a safe and feasible option. Large lesions and anal lip involvement appeared to be factors predictive of difficulty.

Supplementary Material



Publication History

Received: 04 September 2023

Accepted after revision: 29 April 2024

Accepted Manuscript online:
29 April 2024

Article published online:
10 June 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
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