The Retrospective Study Of Therapeutic Out Come And Complication Of Endoscopic Sub Mucosal Dissection (ESD) Of Gastrointestin Al Tract Lesions

Background:Endoscopic submucosal dissection is the minimally invasive endoscopic surgery able to resect the lesions of GI tract in en bloc fashion. However, ample experience and skill is needed to obtain therapeutic efficacy of ESD.Objective:The aim of this study was to determine the therapeutic outcome of ESD by studying the rate of complications and relapse in different types of pathological lesions, in different size and sites of the lesions located in GI tract. Also, the rate of remnants in horizontal and vertical margins of the lesion resected was also evaluated in pathological examination.Design:A retrospective study from 2010 May to 2015 March, single center analysis analysis (South East University affiliated Zhong DA Hospital).Patients:A total of 179 patients. Main Outcome Measurements:t test and chi square test using SPSS software obtained the results.Results:In total 179 patients were studied among which 93 were male and 86 were female. The complication rate, relapse rate and the finding of remnants in both margins of specimen by histopathological examination after ESD surgery were very low (8.9%,5%,11.2%) respectively. The gender of the patients and the size of the lesions were not associated with any kind of occurrence of complications, relapse and the findings of remnants in both margins of the specimen on histopathological examination (P>0.05). The rate of occurrence of complications for different types of lesions (polyp, early cancer, carcinoma, benign tumor and other type lesions) is not statistically significant (P= 0.103). There was no statistical significance in finding of remnant tissue on lateral and vertical margins of specimen for the different types of lesions resected (p= 0.223). However, there was significant statistical difference in the rate of occurrence of relapse for different types of lesions (p= 0.023). The relapse was mostly seen in the carcinomas resected by ESD 3/12; 25% whereas non in polyps 0/19; 0%.Limitations:Single-center analysis.Conclusion:1.Overall, ESD is a safe procedure with good therapeutic outcome which can be used to resect different types of lesions regardless of different locations in gastrointestinal tract.2.The gender of the patient don't have any influence in it's efficacy.3.The remnant tissues can be found on the margins of the specimen resected which may be the result of limited visibility of the resection area and difficulty in performing the procedure but the relation of finding remnant tissues with types, sizes and locations of lesions are not significant.