Effectiveness and Safety of Endoscopic Submucosal Dissection for Colorectal Neoplasm in Patients with High Charlson Comorbidity Index Score: A HASID Multicenter Study

Endoscopic submucosal dissection (ESD) is an effective method for removing early colorectal lesions. However, research on the safety and efficacy of ESD in patients with various underlying conditions remains limited. This study retrospectively examined ESD outcomes in colorectal neoplasm patients fr...

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Published inJournal of clinical medicine Vol. 12; no. 19; p. 6255
Main Authors Kim, Dong-Hyun, Jung, Yong-Wook, Jin, Byung-Chul, Oh, Hyung-Hoon, Song, Hyo-Yeop, Kim, Seong-Jung, Myung, Dae-Seong, Kim, Sang-Wook, Lee, Jun, Seo, Geom-Seog, Joo, Young-Eun, Kim, Hyun-Soo
Format Journal Article
LanguageEnglish
Published Basel MDPI AG 28.09.2023
MDPI
Subjects
Age
Anesthesia
Blood pressure
Cancer
Care and treatment
Clinical medicine
Clinical outcomes
Colorectal cancer
Comorbidity
Data collection
Diabetes
Diagnosis
Dissection
Endoscopy
Hospitals
Intestine, Large
Liver diseases
Medical prognosis
Medical research
Mortality
Oxygen saturation
Patient outcomes
Patients
Relapse
Surgery
Tumors
South Korea
United States > US
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Summary:Endoscopic submucosal dissection (ESD) is an effective method for removing early colorectal lesions. However, research on the safety and efficacy of ESD in patients with various underlying conditions remains limited. This study retrospectively examined ESD outcomes in colorectal neoplasm patients from five tertiary medical centers. The Charlson Comorbidity Index (CCI) and age-adjusted CCI (ACCI) were analyzed, and the differences in complete resection and complication rates were analyzed. The CCI, ACCI, and complication rates tended to gradually increase proportionally, and the complication resection rate increased from CCI 2 to ACCI 4 as the starting point, followed by a decreasing trend. Of these, 140 patients (9.7%) had a CCI score of 3 or higher. The high CCI group was older (70.6% vs. 64.7%, p < 0.01) and had a higher proportion of men (70.7% vs. 58.7%, p < 0.01) than the low CCI group. The high CCI group had a higher incidence of cancer than the low CCI group (77.9% vs. 65.2%, p < 0.01). The en bloc resection rate (90.0% vs. 89.3%, p = 0.79) and complete resection rate (75.7% vs. 81.2%, p = 0.12) were not significantly different between the two groups. Colorectal ESD can be safely and effectively performed in patients with various underlying medical conditions.
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These authors contributed equally to this work.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm12196255