Publication:
Pathologic evaluation of large colorectal endoscopic submucosal dissections: an analysis of 279 cases with emphasis on the importance of multidisciplinary work and establishing examination protocols

dc.contributor.coauthorYılmaz, Serpil
dc.contributor.departmentKUH (Koç University Hospital)
dc.contributor.departmentSchool of Medicine
dc.contributor.kuauthorAdsay, Nazmi Volkan
dc.contributor.kuauthorAslan, Fatih
dc.contributor.kuauthorKapran, Yersu
dc.contributor.kuauthorKulaç, İbrahim
dc.contributor.kuauthorTaşkın, Orhun Çığ
dc.contributor.schoolcollegeinstituteKUH (KOÇ UNIVERSITY HOSPITAL)
dc.contributor.schoolcollegeinstituteSCHOOL OF MEDICINE
dc.date.accessioned2024-11-09T22:48:48Z
dc.date.issued2020
dc.description.abstractBackground: Endoscopic submucosal dissections (ESDs) allow removal of large gastrointestinal tumors and help patients avoid major oncologic surgery. In this study, the challenges and development of approaches toward successfully handling ESDs were analyzed in 279 colorectal specimens (114 rectal, 47 left, 118 right colonic; 90% adenoma with/without carcinoma). Methods: Each specimen was processed according to an established protocol including gross photography, mapping, and total submission for histopathologic examination. Results: Mean lesion size was 4.2 cm (range: 0.5-22 cm; 28% >= 5 cm; 6% >= 10 cm). Invasive carcinoma was present in 38 cases (14%), which had a mean overall tumor size of 3.8 cm (range: 1.1-17.5 cm), and mean largest size of the invasive component was 0.93 cm (range: 0.04-3 cm). Fifteen cases were staged as pT1a (submucosal invasion of <1000 mu m) and 13 cases as pT1b (submucosal invasion of >= 1000 mu m). En-bloc and R0 resection rates were 99.3% and 90.6%, respectively. Conclusion: Various histopathologic challenges were encountered, which were carefully evaluated by dedicated pathologists with familiarity to the subtleties in handling and reporting these specimens. We recommend these specimens to be prepared in the endoscopy suite, submitted to the Pathology Department oriented, pinned, and placed into copious amount of fixative. Total sampling, gross photography, mapping, and proper fixation are crucial components in the histopathologic evaluation. Micromeasurement of invasion depth and substaging per European/Japanese guidelines as well as accurate measurement of the distance from the resection margins are highly recommended. In conclusion, ESD is an adequate method that can be successfully implemented in a tertiary care center to perform en-bloc and margin-free resections of clinically selected large colorectal superficial lesions.
dc.description.indexedbyWOS
dc.description.indexedbyScopus
dc.description.indexedbyPubMed
dc.description.issue6
dc.description.openaccessNO
dc.description.publisherscopeInternational
dc.description.sponsoredbyTubitakEuN/A
dc.description.volume28
dc.identifier.doi10.1177/1066896920918309
dc.identifier.eissn1940-2465
dc.identifier.issn1066-8969
dc.identifier.scopus2-s2.0-85084802610
dc.identifier.urihttps://doi.org/10.1177/1066896920918309
dc.identifier.urihttps://hdl.handle.net/20.500.14288/6396
dc.identifier.wos533087000001
dc.keywordsColorectal adenocarcinoma
dc.keywordsEndoscopic resection
dc.keywordsEndoscopic submucosal dissection
dc.keywordsESD
dc.keywordsPAEM
dc.keywordsPer-anal endoscopic myectomy
dc.keywordsEarly gastric-cancer
dc.keywordsMucosal resection
dc.keywordsClinical-outcomes
dc.keywordsNeoplasia
dc.keywordsEffacacy
dc.keywordsTumors
dc.keywordsESD
dc.language.isoeng
dc.publisherSage Publications Inc
dc.relation.ispartofInternational Journal of Surgical Pathology
dc.subjectPathology
dc.subjectSurgery
dc.titlePathologic evaluation of large colorectal endoscopic submucosal dissections: an analysis of 279 cases with emphasis on the importance of multidisciplinary work and establishing examination protocols
dc.typeJournal Article
dspace.entity.typePublication
local.contributor.kuauthorTaşkın, Orhun Çığ
local.contributor.kuauthorAslan, Fatih
local.contributor.kuauthorKulaç, İbrahim
local.contributor.kuauthorAdsay, Nazmi Volkan
local.contributor.kuauthorKapran, Yersu
local.publication.orgunit1SCHOOL OF MEDICINE
local.publication.orgunit1KUH (KOÇ UNIVERSITY HOSPITAL)
local.publication.orgunit2KUH (Koç University Hospital)
local.publication.orgunit2School of Medicine
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