Endoscopic submucosal dissection of appendicular lesions is feasible and safe: a retrospective multicenter study (with video) - 19/09/23

Doi : 10.1016/j.gie.2023.06.024

Mariana Figueiredo, MD ^1,^⁎, Clara Yzet, MD ¹, Timothée Wallenhorst, MD ², Jérôme Rivory, MD ¹, Florian Rostain, MD ¹, Marion Schaefer, MD ³, Jean-Baptiste Chevaux, MD ³, Sarah Leblanc, MD ⁴, Vincent Lépilliez, MD ⁴, Felix Corre, MD ⁵, Gabriel Rahmi, PhD ⁶, Jérémie Jacques, PhD ⁷, Jérémie Albouys, MD ⁷, Mathieu Pioche, PhD ¹
¹ Endoscopy and Gastroenterology Unit, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
² Endoscopy and Gastroenterology Unit, Pontchaillou University Hospital, Rennes, France
³ Endoscopy and Gastroenterology Unit, Nancy University Hospital, Nancy, France
⁴ Department of Endoscopy and Gastroenterology, Hôpital Privé Jean Mermoz, Lyon, France
⁵ Endoscopy and Gastroenterology Unit, Hôpital Cochin, Paris, France
⁶ Gastroenterology and Endoscopy Unit, Hôpital Européen Georges Pompidou, Paris, France
⁷ Department of Endoscopy and Gastroenterology, Dupuytren University Hospital, Limoges, France

^∗Reprint requests: Mariana Figueiredo, MD, Endoscopy Unit, Digestive Disease Department, Pavillon L, Hôpital Edouard Herriot, 69437 Lyon Cedex France.Endoscopy UnitDigestive Disease DepartmentPavillon LHôpital Edouard HerriotLyon Cedex69437France

Abstract

Background and Aims

Endoscopic submucosal dissection (ESD) is challenging for appendicular lesions. We report the outcomes of ESD in this context.

Methods

We collected data of ESD procedures for appendiceal neoplasia in a multicenter prospective registry. Main study endpoints were R0, en-bloc, and curative resection rates and adverse event rate.

Results

One hundred twelve patients were included, 47 (42%) with previous appendectomy. Fifty-six (50%) were Toyonaga type 3 lesions (15 [13.4%] postappendectomy). En-bloc and R0 resection rates were 86.6% and 80.4%, respectively, with no significant difference associated with different grades of appendiceal invasion (P = .9 and P = .4, respectively) or previous appendectomy (P = .3 for both). The curative resection rate was 78.6%. Additional surgery was performed in 16 cases (14.3%), including 10 (62.5%) Toyonaga type 3 lesions (P = .04). This included the treatment of 5 cases (4.5%) of delayed perforation and 1 acute appendicitis.

Conclusions

ESD for appendicular lesions is a potentially safer and effective alternative to surgery for a significant proportion of patients.

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Abbreviation : ESD

Mappa

Patients and lesions characterization

Esportazione

Vol 98 - N° 4

P. 634-638 - ottobre 2023 Ritorno al numero

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Endoscopic submucosal dissection of appendicular lesions is feasible and safe: a retrospective multicenter study (with video) - 19/09/23

Abstract

Background and Aims

Methods

Results

Conclusions

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