ESD FOR LESIONS PROXIMAL TO THE APPENDICEAL ORIFICE

Abstract

With advances in endoscopic equipment and increased awareness among endoscopists, early-stage neoplastic lesions proximal to the appendiceal orifice are often detected. Recently, ESD has become a common treatment in the colorectal field, with high en-bloc resection rates, and difficult cases can be resected using appropriate devices and ESD strategies. The appendiceal orifice is considered a challenging site because of its anatomical structure, and the risk of perforation is high because of the high frequency of submucosal fibrosis and thin muscle layer. Therefore, it is necessary to consider in advance the endoscopic treatment indications and be proficient in the technique. Additionally, appendicitis may occur after endoscopic treatment of lesions near the appendiceal orifice, and its characteristics should be understood. This study describes the endoscopic treatment indications and methods, focusing on ESD, for lesions proximal to the appendiceal orifice (including cases of extension within the orifice). The safety and efficacy of ESD may improve with the development of new treatment methods eventually.