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

Abstract

Background

Endoscopic submucosal dissection (ESD) for ileocecal valve (ICV) lesions poses unique technical challenges because of its anatomic complexity. This study aimed to evaluate the effectiveness and safety of ESD for ICV lesions.

Methods

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

Results

Baseline characteristics and clinical features of the lesions were not significantly different between the groups. The median procedure time of the ICV group was significantly longer than that of the cecal group (35 min vs. 24 min, respectively; P =.04). There were no significant differences in en bloc resection rates between the ICV and cecal groups (92.2% vs. 97.6%, respectively; P =.14). During the median follow-up of 32 months (IQR, 6–89), there was no case of recurrence in the ICV group. A specimen diameter of ≥25 mm and a circumferential spread of ≥1/2 were factors related to a longer procedure time (specimen diameter: OR=4.2 95%CI, 2.1–15.4, P =.02; circumferential spread: OR=3.7, 95%CI, 1.2–12.7, P =.03).

Conclusion

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