With increasing global life expectancy, the significance of geriatric assessment parameters has increased. Sarcopenia is a crucial assessment parameter and is defined as the age-related loss of muscle mass and strength. Sarcopenia is widely acknowledged as a risk factor for postoperative complications in diverse advanced malignancies and has a detrimental effect on the long-term prognosis. While most studies have primarily concentrated on the correlation between sarcopenia and advanced cancer, more recent investigations have focused on the relationship between sarcopenia and early-stage cancer. Endoscopic submucosal dissection (ESD), which is less invasive than surgical intervention, is extensively employed in the management of early-stage cancer, although it is associated with complications such as bleeding and perforation. In recent years, several reports have revealed the adverse consequences of sarcopenia in patients with early-stage cancer undergoing ESD. This literature review briefly summarizes the recent studies on the association between sarcopenia and ESD.
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Clinical Significance of Sarcopenia in Elderly Patients Undergoing Endoscopic Submucosal Dissection: A Systematic Review and Meta-analysis Yuanhao Su, Yongke Wu, Cheng Li, Yiyuan Zhao, Yunhao Li, Xing Jin, Zhidong Wang Digestive Diseases and Sciences.2024; 69(8): 2970. CrossRef
Background /Aims: Endoscopic submucosal dissection (ESD) for residual or recurrent colorectal lesions after incomplete resection is challenging because of severe fibrosis. This study aimed to compare the efficacy of the pocket-creation method (PCM) with a traction device (TD) with that of conventional ESD for residual or recurrent colorectal lesions.
Methods We retrospectively studied 72 patients with residual or recurrent colorectal lesions resected using ESD. Overall, 31 and 41 lesions were resected using PCM with TD and conventional ESD methods, respectively. We compared patient background and treatment outcomes between the PCM with TD and conventional ESD groups, respectively. The primary endpoints were en bloc resection and R0 resection rates. The secondary endpoints were the dissection speed and incidence of adverse events.
Results En bloc resection was feasible in all cases with PCM with TD, but failed in 22% of cases of conventional ESD. The R0 resection rates for PCM with TD and conventional ESD were 97% and 66%, respectively. Dissection was significantly faster in the PCM with TD group (13.0 vs. 7.9 mm2/min). Perforation and postoperative bleeding were observed in one patient in each group.
Conclusions PCM with TD is an effective method for treating residual or recurrent colorectal lesions after incomplete resection.
Approaches and considerations in the endoscopic treatment of T1 colorectal cancer Yunho Jung The Korean Journal of Internal Medicine.2024; 39(4): 563. CrossRef
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Traction methods for endoscopic submucosal dissection Ji Hyun Kim, Sung Chul Park Journal of Innovative Medical Technology.2024; 2(2): 47. CrossRef
Difficult colorectal polypectomy: Technical tips and recent advances Sukit Pattarajierapan, Hiroyuki Takamaru, Supakij Khomvilai World Journal of Gastroenterology.2023; 29(17): 2600. CrossRef
Endoscopic full-thickness resection versus endoscopic submucosal dissection for challenging colorectal lesions: a randomized trial Gianluca Andrisani, Cesare Hassan, Margherita Pizzicannella, Francesco Pugliese, Massimiliano Mutignani, Chiara Campanale, Giorgio Valerii, Carmelo Barbera, Giulio Antonelli, Francesco Maria Di Matteo Gastrointestinal Endoscopy.2023; 98(6): 987. CrossRef
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Colorectal endoscopic submucosal dissection (ESD) is now a well-established endoscopic treatment for early-stage colorectal neoplasms, especially in Asian countries, including Japan. Despite the spread of colorectal ESD, there are still situations in which achieving successful submucosal dissection is difficult. Various novel techniques and devices have been developed to overcome these difficulties, and past reports have shown that some of these strategies can be applied to colorectal ESD. We review several recent developments in the field. The techniques reviewed include the pocket creation method and traction methods and the devices reviewed include the overtube with balloon and electrosurgical knives with water-jet function. These improved techniques and devices can facilitate safer, more reliable ESDs and expand its applicability and acceptability all over the world.
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