Retrospective study of histological diagnoses of surgical resections from the GI-tractus as a basis for future selection to undergo endoscopic surgery

Abstract

Endoscopic resection (here meaning the use of flexible endoscope and not laparoscopic or otherwise) of superficial gastrointestinal lesions has gained a stronger foothold in Western medical institutions since its introduction in the 1990's. Pioneered by Japanese endoscopists who developed and tested the evidence of using techniques such as endoscopic mucosal resection and endoscopic submucosal dissection, this technology allows the operator to remove an invasive, or pre-invasive lesion depending on endoscopically observable characteristics judged intraoperatively. Final histological analysis by the pathologist leads to a conclusive determination of further recommended therapy. With these endoscopic techniques gradually implemented at the University Hospital of Northern Norway's Department of Gastrointestinal Surgery since 2011, a retrospective analysis was performed to determine how many patients operated with surgical organ resection during the years 2008-2010 could instead have been operated using newly introduced endoscopic techniques, and thereof with curative result. The purpose of this project is to give some quantitative measure of future endoscopic activity at the abovementioned department. The European Society of Gastrointestinal Endoscopy's guidelines were used as retrospective inclusion criteria. In all 278 patients were included in the study. Of these, 45 patients (16%) would have been referred to endoscopic resection based on T-status alone, and 27 (10%) patients would have met the criteria for curative endoscopic resection of their gastrointestinal lesion.