부산대학교 도서관

Introduction: Colorectal cancer is the most frequent neoplasm of the whole gastrointestinal track. Due to screening colonoscopy program, colorectal lesions are often diagnosed at early stage. A vast majority of them are possible to remove endoscopically. However, a substantial percentage of benign lesions in Western centers are still operated. Aim: The aim of this article was to determine the percentage of surgical resections due to benign adenomas in a reference center of endoscopic submucosal dissection (ESD) and colorectal surgery in Poland. Materials and methods: Retrospective analysis of 3 510 patients operated on from 2015 to 2019 in the Center of Bowel Treatment in Brzeziny. Results: We analyzed 3 510 endoscopic and surgical procedures performed in the colon: 601 ESDs; 1 002 endoscopic mucosal resections (EMRs); and 1,907 surgical resections. Out of 601 ESDs, 57 invaded the submucosa, of which 29 (4.8%) were nontherapeutic ESDs. In 5 patients, due to occurrence of post-ESD perforation, an additional surgical intervention was necessary. Out of the 1,002 EMRs, 22 cases (2.2%) were diagnosed with deeply infiltrating cancers, which required surgery. The overall percentage of the need for surgery in the endoscopically treated patients (ESD + mucosectomy) was 3.5% (56/1 603). Among resection surgeries, 15 cases (0.8%) ended with the diagnosis of a benign lesion in the postoperative histopathological examination. Conclusions: Inclusion of advanced endoscopic techniques such as ESD to routine clinical practice in colorectal centers offers clear benefits for the patients. A well-defined and standardized process of qualifying for appropriate treatment allows to significantly reduce the percentage of abdominal approach surgeries due to benign colorectal lesions. [ABSTRACT FROM AUTHOR]