Treatment of XXXX by endoscopic submucosal dissection using an insulated-tip diathermic knife.

@entity1 @entity548 @entity5 @entity344 @entity420 @entity1141
BACKGROUND: Endoscopic submucosal dissection (ESD) is a promising technique for the treatment of large, pre- and early malignant @entity344 . OBJECTIVE: To assess the rates of en bloc resection, incidence of complications, procedure times and therapeutic outcomes of ESD using an insulated-tip diathermic knife; and to investigate predictors of these outcomes based on the final pathological features of biopsy specimens. METHODS: One hundred twenty @entity1 with endoscopically suspected @entity5 who were treated with ESD from January 2006 to December 2009 were evaluated. RESULTS: The mean diameter of the @entity5 in the present cohort was 1.88 cm. The mean diameter of the resected specimens was 3.33 cm. The en bloc resection rate was 90% (108 of 120). The median length of the operation was 64.6 min. The @entity548 and perforation complication rates were 5.0% (six of 120) and 2.5% (three of 120), respectively. Of 10 @entity5 initially diagnosed as @entity420 on biopsy, four were found to be low-grade @entity1141 and six were found to be high-grade @entity1141 after resection and final pathological examination. A total of 112 (93.33%) @entity1 underwent curative treatment, eight @entity1 (6.67%) underwent noncurative treatment with ESD, and two @entity1 (1.67%) experienced local recurrence and subsequently underwent surgery. CONCLUSIONS: ESD is a promising local curative treatment option for @entity5 , but still carries the risks of @entity548 and   or perforation. Differences in the interpretation of histological results among different pathologists and   or between biopsy specimens before ESD and the en bloc tissue specimens after ESD will result in discrepancies.
