Efficacy and safety of colorectal endoscopic submucosal dissection in patients with sarcopenia
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and Other Interventional Techniques
Efficacy and safety of colorectal endoscopic submucosal dissection in patients with sarcopenia Shungo Goto1 · Jun Arimoto2 · Takuma Higurashi3 · Kota Takahashi1 · Naoki Ohkubo1 · Nobuyoshi Kawamura1 · Tetsuya Tamura1 · Hisakuni Tomonari1 · Akito Iwasaki1 · Leo Taniguchi1 · Hideyuki Chiba2 · Kazuhiro Atsukawa1 · Yusuke Saigusa4 · Atsushi Nakajima3 Received: 16 August 2019 / Accepted: 22 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Endoscopic submucosal dissection (ESD) for early-stage colorectal cancer (CRC) has become a common and useful treatment. Although sarcopenia has been identified as an independent risk factor for complications after surgery for CRC, whether sarcopenia is also an independent risk factor for complications after colorectal ESD remains to be clarified. The aim of this study was to compare the outcomes of colorectal ESD in patients with and those without sarcopenia. Methods This is a retrospective cohort study. A total of 334 patients underwent colorectal ESD for 361 neoplasms at Hiratsuka City Hospital from March 2012 to October 2018. The neoplasms were divided into two groups depending on the presence or absence of sarcopenia in the patients. Results Overall, 334 patients underwent colorectal ESD for 361 neoplasms during the study period. We excluded 90 patients (90 neoplasms), and 244 patients (277 neoplasms) were included in the final analysis (134 from the sarcopenia group, 137 from the non-sarcopenia group). The en-bloc resection rate was high and was not significantly different between the sarcopenia group [126/134 (94.1%)] and the non-sarcopenia group [133/137 (97.1%)], P = 0.1778). The rate of perforation and the rate of delayed bleeding were not significantly different between the sarcopenia group and the non-sarcopenia group [6/134 (4.5%) vs. 9/137 (6.6%), P = 0.314, 4/134 (3%) vs. 6/137 (4.4%), P = 0.3885, respectively]. Conclusions The presence of sarcopenia did not influence the rate of complications after ESD. Colorectal ESD is safe and effective even in patients with sarcopenia. Prospective multicenter studies are necessary to confirm our results. Keywords Colorectal neoplasms · Sarcopenia · Endoscopic submucosal dissection Abbreviations CRC Colorectal cancer ESD Endoscopic submucosal dissection CT Computed tomography PECS Post-ESD coagulation syndrome POD Post-ESD day * Atsushi Nakajima nakajima‑[email protected] 1
Department of Gastroenterology, Hiratsuka City Hospital, Hiratsuka, Japan
2
Department of Gastroenterology, Omori Red Cross Hospital, Tokyo, Japan
3
Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3‑9 Fukuura, Kanazawa‑ku, Yokohama 236‑0004, Japan
4
Department of Biostatistics, Yokohama City University School of Medicine, Yokohama, Japan
SMI Skeletal muscle index SD Standard deviation OR Odds ratio 95% CI 95% Confidence interval LAC Laparoscopic-assisted colectomy OS Overall survival Colorectal c
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