COLORECTAL ENDOSCOPIC SUBMUCOSAL DISSECTION: DO WE MEET THE RECOMMENDATIONS OF THE ESGE? A SPANISH MULTICENTRE PROSPECTIVE STUDY

JC Marín-Gabriel; AH de Tejada; F Ramos-Zabala; E Albéniz-Arbizu; Á Terán-Lantarón; PJ Rosón-Rodríguez; A Amorós-Tenorio; D García-Romero; J Rodríguez-Sánchez; H Uchima-Koecklin; J Santiago-García; A Sánchez-Yagüe; G Fernández-Esparrach; Ó Nogales-Rincón; C Guarner-Argente; P de María; C Dolz-Abadía; ER de Santiago; AJ del Pozo-García; A Álvarez-Delgado; H Cortés-Pérez; R Durán-Bermejo; ESD Interest Group - GSEED Endoscopic Resection Working Group

doi:10.1055/s-0040-1704255

Endoscopy, Table of Contents

Endoscopy 2020; 52(S 01): S84-S85
DOI: 10.1055/s-0040-1704255

ESGE Days 2020 oral presentations

Friday, April 24, 2020 11:00 – 13:00 Unlock en-bloc 2 Liffey Meeting Room 2

COLORECTAL ENDOSCOPIC SUBMUCOSAL DISSECTION: DO WE MEET THE RECOMMENDATIONS OF THE ESGE? A SPANISH MULTICENTRE PROSPECTIVE STUDY

JC Marín-Gabriel

¹12 de Octubre’ University Hospital, Gastroenterology, Endoscopy Unit, Madrid, Spain

,

AH de Tejada

²Puerta de Hierro - Majadahonda’ University Hospita, Gastroenterology, Endoscopy Unitl, Majadahonda (Madrid), Spain

,

F Ramos-Zabala

³HM Montepríncipe’ University Hospital, Gastroenterology, Endoscopy Unit, Boadilla del Monte (Madrid), Spain

,

E Albéniz-Arbizu

⁴Complejo Hospitalario de Navarra, Gastroenterology, Endoscopy Unit, Pamplona, Spain

,

Á Terán-Lantarón

⁵Marqués de Valdecilla’ University Hospital, Gastroenterology, Endoscopy Unit, Santander, Spain

,

PJ Rosón-Rodríguez

⁶Hospital Quirón Salud Málaga, Gastroenterology, Endoscopy Unit, Málaga, Spain

,

A Amorós-Tenorio

⁷Nra. Sra. de la Candelaria’ University Hospital, Gastroenterology, Endoscopy Unit, Tenerife, Spain

,

D García-Romero

⁷Nra. Sra. de la Candelaria’ University Hospital, Gastroenterology, Endoscopy Unit, Tenerife, Spain

,

J Rodríguez-Sánchez

¹12 de Octubre’ University Hospital, Gastroenterology, Endoscopy Unit, Madrid, Spain

,

H Uchima-Koecklin

⁸Hospital Germans Trias i Pujol, Gastroenterology, Endoscopy Unit, Badalona, Spain

,

J Santiago-García

²Puerta de Hierro - Majadahonda’ University Hospita, Gastroenterology, Endoscopy Unitl, Majadahonda (Madrid), Spain

,

A Sánchez-Yagüe

⁹Costa del Sol’ Health Agency, Gastroenterology, Endoscopy Unit, Marbella (Málaga), Spain

,

G Fernández-Esparrach

¹⁰Hospital Clínic Barcelona, IDIBAPS, University of Barcelona, Gastroenterology, Endoscopy Unit, Barcelona, Spain

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Ó Nogales-Rincón

¹¹Gregorio Marañón’ University Hospital, Gastroenterology, Endoscopy Unit, Madrid, Spain

,

C Guarner-Argente

¹²’Santa Creu i Sant Pau’ University Hospital, Gastroenterology, Endoscopy Unit, Barcelona, Spain

,

P de María

¹³La Paz’ University Hospital, Gastroenterology, Endoscopy Unit, Madrid, Spain

,

C Dolz-Abadía

¹⁴’Son Llatzer’ Hospital, Gastroenterology, Endoscopy Unit, Palma de Mallorca, Spain

,

ER de Santiago

¹⁵Ramón y Cajal’ University Hospital, Gastroenterology, Endoscopy Unit, Madrid, Spain

,

AJ del Pozo-García

¹12 de Octubre’ University Hospital, Gastroenterology, Endoscopy Unit, Madrid, Spain

,

A Álvarez-Delgado

¹⁶Complejo Hospitalario de Salamanca, Gastroenterology, Endoscopy Unit, Salamanca, Spain

,

H Cortés-Pérez

¹⁷Hospital de Urduliz, Gastroenterology, Endoscopy Unit, Urduliz, Spain

,

R Durán-Bermejo

¹⁸ServiDigest Clínic, Gastroenterology, Endoscopy Unit, Barcelona, Spain

,

ESD Interest Group - GSEED Endoscopic Resection Working Group

› Author Affiliations

Abstract

Full Text

Aims The ESGE has recently proposed some quality metrics concerning CR-ESD: En bloc resection rates >90%, perforation rate < 3% and the need for surgery because of complications < 1%.

Methods Consecutive patients were enrolled in a prospective multicentre Spanish CR-ESD registry since January 2016 to August 2019. Since the ESGE recommends a minimum case load of 25 ESD procedures per year, the quality metrics were analysed in centres that met this proposed standard.

Results We recruited 896 CR neoplasms submitted for an ESD and performed by members of the ESD interest group of the GSEED Endoscopic Resection Working Group. Seven centres met the standard of performing > 25 CR-ESD/year. The mean CR-ESD/year values were 76 (hospital A), 66 (B), 56 (C), 34 (D), 32 (E), 32 (F), and 26 (G). The case load of CR-ESD for this period was: 244 (A), 192 (B), 121 (C), 63 (D), 57 (E), 71 (F) and 59 (G), respectively. Finally, 807 CR-ESD were analysed. The en bloc resection rate was: 96%, 89, 81, 96.8, 64.9, 87.3 and 76.3, respectively. The intraprocedural perforation rate was: 29.1%, 1, 14, 3.2, 14, 14.1 and 8.5%, respectively. The delayed perforation rate was: 2.1, 1, 5.2, 0, 5.4, 3.1 and 3.5%, respectively. The need for surgery because of perforation was: 2.9%, 1, 1.7, 0, 3.5, 2.8 and 3.4%, respectively. Additionally, the need for surgery because of bleeding was: 0.4%, 0.5, 0, 0, 1.8, 1.4 and 1.7%, respectively.

Conclusions Recommendations according the ESGE position statement were met in 2 centres concerning the en bloc resection rate (A and D). The statement regarding the overall perforation rate was met in 1 case (B), and the recommendation concerning the need for surgery was met in 1 hospital (D). None of them fulfilled all the quality criteria although 2 of them were close to meet them.