| Featured Session 1 (JGES,JSGE,JSGS) |
| Fri. November 1st 9:00 - 11:00 Room 1: Kobe International Exhibition Hall No.2 Building Hall (North) |
| Treatment strategy and outcomes of ESD for cecal lesions in proximity to the appendiceal orifice | |||
| Ryosuke Ishida1, Tetsuya Yoshizaki1, Takashi Toyonaga1 | |||
| 1Department of Gastroenterology, Kobe University | |||
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| Background:ESD for cecal lesions in proximity to the appendiceal orifice (L-PAO) is challenging due to the direct confrontation with the muscle layer, poor scope operability, and the presence of fibrosis. Methods:Between August 2008 and December 2023, 112 cases of cecal lesions located within approximately 12 mm of the appendiceal orifice were included. Lesions were classified based on their relationship with the appendiceal orifice (types 0-3), and treatment strategies were divided into two approaches (Strategies A or B). We retrospectively reviewed the treatment experience of L-PAO and report the outcomes, along with presenting a video of a case where en bloc resection to the appendiceal root was achieved. Results:Strategy A was used in 84 cases (type 0/1/2 : 46/35/3) and strategy B in 28 cases (type 1/2/3 : 3/8/17). The median specimen size was 38 mm (range 10-114 mm) and the median tumour size was 28 mm (3-110 mm). The en bloc resection rate was 96.4% (108/112 cases), and the complete resection rate was 83.9% (94/112 cases). Postoperative bleeding occurred in 2 cases, Post-ESD Coagulation Syndrome in 19 cases, intraoperative perforation in 13 cases, and postoperative appendicitis in 3 cases. Conclusion:For lesions near the appendiceal orifice, it is important to develop a treatment strategy based on the location of the lesion relative to the appendix. |
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Index Term 1: endoscopic submucosal dissection Index Term 2: appendiceal orifice |
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