Publication Date
5-27-2024
Journal
World Journal of Hepatology
DOI
10.4254/wjh.v16.i5.784
PMID
38818291
PMCID
PMC11135272
PubMedCentral® Posted Date
5-27-2024
PubMedCentral® Full Text Version
Post-Print
Published Open-Access
yes
Keywords
Endoscopic aubmucosal dissection, Cirrhosis, Advanced polypectomy, Intraprocedural bleeding, Colon cancer
Abstract
BACKGROUND: Among patients with cirrhosis and pre-malignant or early malignant mucosal lesions, surgical intervention carries a much higher bleeding risk. When such lesions are discovered, endoscopic submucosal dissection (ESD) may offer curative therapy with lower risks than surgery and improved outcomes compared to traditional endoscopic resection.
AIM: To evaluate the outcomes of ESD in patients with cirrhosis.
METHODS: Patients with cirrhosis undergoing ESD between July 2015 and August 2022 were retrospectively matched in 1:2 fashion to controls based on lesion location, size, and anticoagulation use. Procedural outcomes were compared between groups.
RESULTS: A total of 64 Lesions from 59 patients were included (16 cirrhosis, 43 control). There were no differences in patient or lesion characteristics between groups. En bloc and curative resection was achieved in 84.21%, 78.94% of the cirrhosis group and 88.89%, 68.89% of controls, respectively, with no significant differences. Cirrhotic patients had significantly higher rates of intra-procedural coagulation grasper use for control of bleeding (47.37%
CONCLUSION: ESD may be safe and effective in patients with cirrhosis. Most procedure related outcomes were not significantly different between groups. Intra-procedural bleeding requiring use of the coagulation grasper use was expectedly higher in the cirrhosis group given the known effects of liver disease on hemostasis.
Included in
Digestive System Diseases Commons, Gastroenterology Commons, Medical Sciences Commons, Oncology Commons
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