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DOI: 10.1055/s-0040-1704087
OUTCOMES FROM THE UK ENDOSCOPIC SUBMUCOSAL DISSECTION (UK ESD) REGISTRY: IS AN ALTERNATIVE APPROACH VIABLE FOR ENDOSCOPISTS IN THE WESTERN SETTING?
Publikationsverlauf
Publikationsdatum:
23. April 2020 (online)
Aims To analyse UK ESD practice through the development of the first UK national ESD registry:
Methods The UK ESD registry was established in 2016 with 4 major tertiary referral centres which was extended to 6 centres by 2019. Data on different parameters ranging from patient demographics to procedural details were collected on a national web based electronic platform and analysed.
Results A total of 309 ESDs were performed with a completion rate of 99.1%. Standard ESD was performed in 73.5% whereas Knife Assisted Resection (KAR) was performed in 26.5% cases. The mean lesion size was 3.8 cm. The en bloc resection rate was 86.5%, whereas the R0 resection rate was 72.5%.
There were 11 (3.6%) cases with complications (7 significant bleeds and 4 perforations). Majority of the colorectal lesions showed a resection histology of LGD (71%) with cancer demonstrated in roughly 10% of the lesions, whereas upper GI lesions showed a higher percentage of atleast SM1 invasive cancer (stomach- 61% and oesophagus-67%)
Further details comparing standard ESD technique and KAR have been outlined in [Table 1].
Conclusions We conclude that En bloc resection rates were higher in standard ESD, than in KAR, however, KAR was involved with fewer complications. KAR was most commonly employed for colorectal lesions. Although associated with a lower en bloc resection rate, KAR could be an attractive learning step for western endoscopists to be fully competent in standard ESD, especially in colorectal lesions, in view of the lower incidence of SM invasive cancers demonstrated in them.