786 Safety of Anesthesia-Assisted Sedation With Propofol for Advanced Endoscopic Procedures in Obese Individuals

Abstract

delayed perforation (0.4%) and 17 cases of postoperative bleeding (1.5%). Large tumor size 50mm was an independent risk factor for complications whereas large number of ESDs performed by an institution decreased risk of complications. Among the 1,111 ESD cases, 648 cases involving non-curative resections, SMTs or non-neoplastic lesions, other invasive cancers and follow-up periods 6 months were excluded leaving a total of 463 lesions eligible for the recurrence and survival analyses. The overall median follow-up period was 30 52 months. There were six locally recurrent tumors (1.3%) with a 22 22 months disease free follow-up period. Three of the six recurrent tumors had originally been resected piecemeal, however, all six recurrent tumors were successfully resected endoscopically. There were two cases of metachronous colon cancer and one case of distant metastases to the liver and lungs during the study period. During the median follow-up period, no patients died of colorectal cancer so both the disease-specific and overall survival rates were 100%. Conclusions: ESD performed by experienced endoscopists is an effective alternative treatment to surgery providing high en-bloc and curative resection rates for large superficial colorectal tumors. The relatively long-term outcomes were excellent, but further follow-up evaluation and assessment of a prospective case series are necessary.