Kaosombatwattana U, Yamamura T, Nakamura M, Hirooka Y, Goto H. Colorectal endoscopic submucosal dissection in special locations. World J Gastrointest Endosc 2019; 11(4): 262-270 [PMID: 31040887 DOI: 10.4253/wjge.v11.i4.262]
Corresponding Author of This Article
Takeshi Yamamura, MD, PhD, Assistant Professor, Department of Endoscopy, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8560, Japan. tyamamu@med.nagoya-u.ac.jp
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Uayporn Kaosombatwattana, Masanao Nakamura, Hidemi Goto, Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya 466-8560, Japan
Uayporn Kaosombatwattana, Division of Gastroenterology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
Takeshi Yamamura, Yoshiki Hirooka, Department of Endoscopy, Nagoya University Hospital, Nagoya 466-8560, Japan
Author contributions: Kaosombatwattana U and Yamamura T contributed equally to this work; Kaosombatwattana U, Yamamura T, Nakamura M, Hirooka Y and Goto H designed the review; Kaosombatwattana U and Yamamura T performed literature review; Kaosombatwattana U and Yamamura T wrote the manuscript; Kaosombatwattana U, Yamamura T, Nakamura M, Hirooka Y and Goto H approved the manuscript.
Conflict-of-interest statement: All authors declare no personal or professional conflicts of interest, and no financial support from the companies that produce and/or distribute the drugs, devices, or materials described in this report.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Takeshi Yamamura, MD, PhD, Assistant Professor, Department of Endoscopy, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8560, Japan. tyamamu@med.nagoya-u.ac.jp
Telephone: +81-52-7442172 Fax: +81-52-7442180
Received: February 8, 2019 Peer-review started: February 10, 2019 First decision: February 19, 2019 Revised: March 17, 2018 Accepted: March 26, 2019 Article in press: March 26, 2019 Published online: April 16, 2019 Processing time: 70 Days and 14.3 Hours
Abstract
Colorectal endoscopic submucosal dissection (ESD) is considered one of the most challenging endoscopic procedures for novice endoscopists. When compared with the stomach, the colon and rectum have a narrower tubular lumen, greater angulation at the flexures, and a thinner muscle layer. These factors make endoscopic control and maneuverability difficult. ESD of the colorectum was considered more difficult than gastric and esophageal ESD. However, with learning from the experts, practicing, and selecting an appropriate technique, most of colorectal ESD could be performed successfully. Nevertheless, some colorectal locations are extremely specialized either from unique anatomy or given unstable scope position. Accordingly, the objective of this review was to provide endoscopists with an overview of the techniques and outcomes associated with ESD at these special colorectal locations. ESD at the discussed special locations of the ileo-colo-rectum was found to be feasible, and outcomes were comparable to those of ESD performed in non-special locations of the ileo-colo-rectum. Practice for skill improvement and awareness of the unique characteristics of each special location is the key to performing successful ESD.
Core tip: Colorectal endoscopic submucosal dissection (ESD) involving ileocecal valve, appendiceal orifice or anal canal is considered to be extremely challenging for novice ESD endoscopist. With well-prepared strategies and appropriate assisting devices, the successful procedures with less complications can be achieved. We made great efforts to review and summarize the currently proposed techniques to overcome these difficulties.
