Outcome and predictive factors for perforation in orthodontic rubber band-assisted endoscopic submucosal dissection of fibrotic colorectal lesions.
Endoscopic mucosal dissection
Fibrosis
Orthodontic rubber band
Perforate
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
12 Aug 2024
12 Aug 2024
Historique:
received:
02
03
2024
accepted:
09
07
2024
medline:
13
8
2024
pubmed:
13
8
2024
entrez:
12
8
2024
Statut:
epublish
Résumé
Endoscopic submucosal dissection (ESD) of fibrotic colorectal lesions is difficult and has a high complication rate. There are only a few reports on the utility of orthodontic rubber band (ORB) traction in reducing the difficulty of this procedure. This study aimed to investigate the risk factors for perforation when applying ORB traction during ESD of fibrotic colorectal lesions. We continuously collected the clinical data of 119 patients with fibrotic colorectal lesions who underwent ESD with ORB and clip traction between January 2019 and January 2024. Possible risk factors for perforation were analyzed. The median ORB-ESD operative time was 40 (IQR 28-62) min, and the en bloc and R0 resection rates were 94.1% and 84.0%, respectively. Perforation occurred in 16 of 119 patients (13.4%). The lesion size, lesion at the right half of the colon or across an intestinal plica, the degree of fibrosis, operation time, and the surgeon's experience were associated with perforation during ORB-ESD (P < 0.05). Multivariate logistic regression analysis showed that lesions in the right colon (OR 9.027; 95% CI 1.807-45.098; P = 0.007) and those across an intestinal plica (OR 7.771; 95% CI 1.298-46.536; P = 0.025) were independent risk factors for perforation during ORB-ESD. ORB-ESD is an effective and feasible approach to treat fibrotic colorectal lesions. Adequate preoperative evaluation is required for lesions in the right colon and across intestinal plicas to mitigate the risk of perforation.
Identifiants
pubmed: 39134559
doi: 10.1038/s41598-024-67214-3
pii: 10.1038/s41598-024-67214-3
doi:
Substances chimiques
Rubber
9006-04-6
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
18648Subventions
Organisme : the Fujian Science and Technology Guiding Fund Project
ID : 2023Y0070
Organisme : the Foreign Cooperation Project of the Department of Science and Technology of Fujian Province
ID : 2022I0033
Organisme : Key Subject Funds of Joint Logistics Support Force
ID : LQZD-XH
Informations de copyright
© 2024. The Author(s).
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