122 research outputs found
A Study about Processing Procedure of the Aged Abuse Crime in the 「Act on Special Cases concerning the Punishment, etc. of the Aged Abuse Crime(Bill)」 and Its Improvement
Reporting Systems of Elder Abuse in 「Welfare of Older Persons Act」and Their Improvement Measures
A REVIEW OF MAJOR DECISIONS OF THE CONSTITUTIONAL COURT RELATED TO CRIMINAL PROCEDURES MADE IN 2017
Long-term clinical outcomes of endoscopic submucosal dissection for colorectal neoplasia with or without the hybrid technique
Background and aims:
Few studies have addressed the long-term outcomes of hybrid endoscopic submucosal dissection (ESD-H) in the colorectum. We did so in our current study in comparison with a conventional colorectal ESD approach in which submucosal dissection was continued throughout, until the completion of resection (ESD-T).
Method: The medical records of 836 colorectal neoplasia patients treated by ESD-T or ESD-H were reviewed retrospectively. ESD-H was defined as colorectal ESD with additional snaring in the final stage of the procedure. Primary outcomes were the overall and metastatic recurrence rates. Secondary outcomes were short-term outcomes such as the en bloc resection rate, procedure time and adverse events.
Result: The overall recurrence rate was higher in the ESD-H than in the ESD-T group (5.7% vs 0.7%, p = 0.001). The metastatic recurrence rate showed no significant difference between these groups (1.4% vs 1.4%, p = 1.000). Multivariate analysis revealed that a failed en bloc resection (HR 24.097, 95% CI 5.446-106.237; p < 0.001) and larger tumor size (HR 1.042 95% CI 1.014-1.070; p = 0.003) were independently associated with overall recurrence. The ESD-H group showed a lower en bloc resection rate (56.8% vs 96.5%, p < .001), shorter procedure time (45.6 vs 54.3 min, P < .001) and higher perforation rate (10.3% vs 6.0%, p = .029).
Conclusion: Although long-term outcomes in terms of overall recurrence are inferior following ESD-H, a failed en bloc resection and large tumor size are the only independent risk factors for recurrence. Further investigations are warranted to improve the long-term outcomes of ESD-H.Maste
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