Copyright
©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Jul 10, 2016; 8(13): 466-471
Published online Jul 10, 2016. doi: 10.4253/wjge.v8.i13.466
Efficacy and safety of endoscopic submucosal dissection under general anesthesia
Kanefumi Yamashita, Hironari Shiwaku, Toshihiro Ohmiya, Hideki Shimaoka, Hiroki Okada, Ryo Nakashima, Richiko Beppu, Daisuke Kato, Takamitsu Sasaki, Seiichiro Hoshino, Satoshi Nimura, Ken Yamaura, Yuichi Yamashita
Kanefumi Yamashita, Hironari Shiwaku, Toshihiro Ohmiya, Hideki Shimaoka, Hiroki Okada, Ryo Nakashima, Richiko Beppu, Daisuke Kato, Takamitsu Sasaki, Seiichiro Hoshino, Yuichi Yamashita, Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka 814-0180, Japan
Satoshi Nimura, Department of Pathology, Fukuoka University Faculty of Medicine, Fukuoka 814-0180, Japan
Ken Yamaura, Department of Anesthesiology, Fukuoka University Faculty of Medicine, Fukuoka 814-0180, Japan
Author contributions: Yamashita K and Shiwaku H equally contributed to this work; Yamashita K collected and analyzed the data and drafted the manuscript; Shiwaku H provided analytical oversight; Sasaki T designed and supervised the study; Nimura S, Yamaura K and Yamashita Y revised the manuscript for important intellectual content; Nimura S, Yamaura K and Yamashita Y offered the technical or material support; Ohmiya T, Shimaoka H, Okada H, Nakashima R, Beppu R, Kato D, Sasaki T and Hoshino S provided administrative support; all authors have read and approved the final version to be published.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of the Fukuoka University Faculty of Medicine.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Hironari Shiwaku, MD, Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Nanakuma 7-45-1, Jonan-ku, Fukuoka 814-0180, Japan. hiro.shiwaku@gmail.com
Telephone: +81-92-8011011 Fax: +81-92-8639759
Received: February 14, 2016
Peer-review started: February 15, 2016
First decision: March 23, 2016
Revised: April 21, 2016
Accepted: May 17, 2016
Article in press: May 27, 2016
Published online: July 10, 2016
AIM: To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) under general anesthesia.
METHODS: From January 2011 to July 2014, 206 consecutive patients had undergone ESD under general anesthesia for neoplasms of the stomach, esophagus, and colorectum were enrolled in this retrospective study. The efficacy and safety of ESD under general anesthesia were assessed.
RESULTS: The en bloc resection rate of esophageal, gastric, and colorectal lesions was 100.0%, 98.3%, and 96.1%, respectively. The complication rate of perforation and bleeding were 0.0% and 0.0% in esophageal ESD, 1.7% and 1.7% in gastric ESD, and 3.9% and 2.0% in colorectal ESD, respectively. No cases of aspiration pneumonia were observed. All complications were managed by conservative treatment, with no surgical intervention required.
CONCLUSION: With the cooperation of an anesthesiologist, ESD under general anesthesia appears to be a useful method, decreasing the risk of complications.
Core tip: Studies regarding endoscopic submucosal dissection (ESD) under general anesthesia in Japan are scarce because ESD is generally performed under conscious sedation. ESD requires minimal patient movement for optimal visualization, which may be hampered because of insufficient sedation. Thus, this retrospective study aimed to evaluate the efficacy and safety of ESD under general anesthesia in 206 consecutive patients. The complication rate was lower in our study than in previous studies. Moreover, no cases of aspiration pneumonia were observed. ESD under general anesthesia appears to be a useful method for reducing the risk of complications.
