Krijgsheld, Bennie (2024) Outcomes of Local Endoscopic Resection in Colorectal Cancer: A Quality Assessment in a Medium-Sized Teaching Hospital. thesis, Medicine.
Full text available on request.Abstract
Introduction With the advent of screening programs for colorectal cancer (CRC), tumors can be treated in an early stage with local endoscopic resection. However, with this approach, locoregional lymph nodes remain in situ. Local endoscopic resection is a difficult procedure which is usually done in an academic setting. This is a quality control project to gain insight in the immediate and long-term results in a medium-sized teaching hospital. Methods Data from all patients treated with local excision between 2015 and 2024 were collected from Deventer Hospital. All lesions, benign and malignant, were evaluated. The main outcomes were the percentages of successful procedures, complications, and recurrence of benign and malignant lesions. Known risk factors for recurrence were considered. Results A total of 441 patients were included with a mean follow-up of 19 months. Local excision was successful in 85% of the cases in suspected polyps or early cancer (SPEC), of which 146 resections (44.5%) turned out to be malignant. 74 malignancies (50.7%) had one or more histological risk factors, with a recurrence of 9.1% after a median follow-up of 19 months. This is in accordance with the TESAR trial. The complication rate was 6%, which is relatively low. In patients referred for excision of scarry tissue after previous endoscopic attempts to remove malignancies the procedures were successful in 87.5% (n=28) of the cases, 9 lesions turned out to be malignant (28.1%), with a recurrence of 25%. This was usually done with EFTR. In the adenomatous recurrences in scarry tissue, 3 malignancies were found with one recurrence. A complication rate of 7% was seen from the total of 100 procedures in these two groups. Excision after chemoradiotherapy and inflammatory disease turned out to be safe with a successful rate of 80% and 100% respectively. No tumor recurrence was seen in these groups. Local scarring was most associated with tumor recurrence. Histological risk score was second to local scarring. Conclusion The success rate of local endoscopic resection mainly depends on the experience of the team, and not the hospital setting. In this study the results are not inferior to those reported in the literature.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Borg, dr. F. ter |
| Faculty: | Medical Sciences |
| Date Deposited: | 19 Nov 2025 14:50 |
| Last Modified: | 19 Nov 2025 14:50 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3860 |
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