Endoscopic Mucosal Resection with Circumferential Mucosal Incision for Colorectal Neoplasms: Comparison with Endoscopic Submucosal Dissection and between Two Endoscopists with Different Experiences

Clinical Endoscopy 2017년 50권 4호 p.379 ~ p.387

양동훈(Yang Dong-Hoon) - University of Ulsan College of Medicine Asan Medical Center Department of Gastroenterology
곽민섭(Kwak Min-Seob) - University of Ulsan College of Medicine Asan Medical Center Department of Gastroenterology
박상형(Park Sang-Hyoung) - University of Ulsan College of Medicine Asan Medical Center Department of Gastroenterology
예병덕(Ye Byong-Duk) - University of Ulsan College of Medicine Asan Medical Center Department of Gastroenterology
변정식(Byeon Jeong-Sik) - University of Ulsan College of Medicine Asan Medical Center Department of Gastroenterology
명승재(Myung Seung-Jae) - University of Ulsan College of Medicine Asan Medical Center Department of Gastroenterology
양석균(Yang Suk-Kyun) - University of Ulsan College of Medicine Asan Medical Center Department of Gastroenterology
김현건(Kim Hyun-Gun) - Soonchunhyang University College of Medicine Institute for Digestive Research
(Friedland Shai) - Stanford University School of Medicine Department of Gastroenterology and Hepatology

Abstract

Background/Aims: Endoscopic mucosal resection with circumferential mucosal incision (CMI-EMR) may offer benefits comparable to those of endoscopic submucosal dissection (ESD), while requiring less technical proficiency than ESD.

Methods: We retrospectively compared the outcomes of CMI-EMR (n=34) and size-matched ESD (n=102), which were performed by a Korean endoscopist for colorectal epithelial lesions of 20?35 mm. Procedural parameters of CMI-EMRs performed by an American ESD novice (n=30) were compared with those performed by the Korean endoscopist.

Results: The lesion size was 22.3±3.9 mm and 22.9±2.4 mm in the CMI-EMR and size-matched ESD groups, respectively (p=0.730). The resection time was 12.7±7.0 minutes in the CMI-EMR group and 45.6±30.1 minutes in the ESD group (p<0.001). The en bloc resection rate was 94.1% in the CMI-EMR group and 100% in the ESD group (p=0.061). There were no differences in the en bloc resection and complication rates of CMI-EMRs between a Korean and an American endoscopist.

Conclusions
For the treatment of moderate-size colorectal lesions, CMI-EMR showed a trend toward lower en bloc resection rate, but required shorter procedure time than ESD. CMI-EMR outcomes were similar when performed by a Korean ESD expert and an American ESD novice.

키워드

Neoplasms, Colon, Rectum, Endoscopic mucosal resection, Endoscopic submucosal dissection
원문 및 링크아웃 정보
등재저널 정보
학술진흥재단(KCI) KoreaMed 대한의학회 회원 
주제코드
주제명(Target field)
연구대상(Population)
연구참여(Sample size)
대상성별(Gender)
질병특성(Condition Category)
연구환경(Setting)
연구설계(Study Design)
연구기간(Period)
중재방법(Intervention Type)
중재명칭(Intervention Name)
키워드(Keyword)
유효성결과(Recomendation)
comparising between circumferential mucosal incision (CMI-EMR) and endoscopic submucosal dissection (ESD) was similar in terms of outcomes.
연구비지원(Fund Source)
근거수준평가(Evidence Hierarchy)
출판년도(Year)
참여저자수(Authors)
대표저자
KCD코드
ICD 03
건강보험코드