A retrospective study on endoscopic submucosal dissection for the treatment of ileocecal valve lesions.

Abstract

Background and aims: Endoscopic submucosal dissection (ESD) for ileocecal valve (ICV) lesions poses unique technical challenges due to anatomical complexity. The study aimed to evaluate the effectiveness and safety following ESD for lesions at the ICV.

Methods: From December 2016 to June 2023, we reviewed the clinic characteristics and outcome of ESD on 51 ICV lesions and 84 cecal lesions. Factors related to longer procedure time were analyzed for ESD of ICV lesions.

Results: Baseline characteristics and clinical features of lesions were not significantly different between the groups. The median procedure time of ICV group was significantly longer than that of the cecal group (35min and 24min, respectively; P=0.04). There were no significant differences in en bloc resection rate (92.2% and 97.6%, respectively; P=0.14) between the groups. During the median follow-up of 32 months (range 6-89), there was no case of recurrence in ICV groups. A specimen diameter of ≥25mm and circumferential spread ≥1/2 were factors related to a longer procedure time (OR5.6, 95%CI 1.7 to 18.9, P=0.02; OR 4.4, 95%CI 1.3 to 14.6, P=0.04, respectively).

Conclusions: ESD for ICV lesions requires a longer procedure duration than for cecal lesions but is safe and effective, making it a challenging and promising therapeutic approach.