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Related Experiment Video

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Structured Approach to Colonoscopy Technique Optimization: A Single-Center Experience with Novice Endoscopists

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Endoscopic balloon dilation for obstructive colorectal cancer: a basic study on morphologic and pathologic features

Akira Tanaka¹, Sotaro Sadahiro, Masanori Yasuda

¹Department of Gastroenterological Surgery, Tokai University School of Medicine, Isehara, Japan. atanaka@is.icc.u-tokai.ac.jp

Gastrointestinal Endoscopy

|April 6, 2010

Summary

Perforation during colorectal cancer (CRC) treatment is a risk. Severe stricture and collagen fiber proliferation in CRC specimens predict perforation, not procedural factors.

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Flexible Colonoscopy in Mice to Evaluate the Severity of Colitis and Colorectal Tumors Using a Validated Endoscopic Scoring System

Flexible Colonoscopy in Mice to Evaluate the Severity of Colitis and Colorectal Tumors Using a Validated Endoscopic Scoring System

Published on: October 16, 2013

Area of Science:

Gastroenterology
Surgical Oncology
Pathology

Background:

Endoscopic dilation and stenting for colorectal cancer (CRC) strictures carry a 1%-17% risk of perforation.
Perforation can occur before surgery or as a palliative measure, potentially avoiding colostomy.

Purpose of the Study:

To experimentally identify risk factors for perforation in excised colorectal cancer specimens.
Investigate correlations between macroscopic perforation and tumor characteristics.

Main Methods:

Ex vivo study on 47 surgically resected, human colon cancer specimens with strictures (<15 mm diameter).
An 18 mm balloon was inflated within the stricture to simulate dilation.
Correlated perforation with 20 morphological and histopathological features.

Main Results:

Perforation occurred in 17.0% (8/47) of specimens.
Significant predictors of perforation included: peritumoral collagen fiber proliferation (≥23.9%), tumor annularity, severe stricture (<7.9 mm), and reduced smooth muscle cells.
A combination of severe stricture and collagen proliferation best predicted perforation.

Conclusions:

Histopathological and morphological factors reducing elastic compliance are key predictors of perforation.
These factors are more critical than procedural parameters like balloon pressure.