Environmental impact of endoscopic submucosal dissection versus piecemeal resection for large colonic adenomas : a post hoc analysis of the resect colon study - Archive ouverte HAL Accéder directement au contenu
Communication Dans Un Congrès Année : 2023

Environmental impact of endoscopic submucosal dissection versus piecemeal resection for large colonic adenomas : a post hoc analysis of the resect colon study

R. Grau
  • Fonction : Auteur
T. Wallenhorst
  • Fonction : Auteur
C. Jean-Baptiste
  • Fonction : Auteur
L. Vincent
  • Fonction : Auteur
C. Stanislas
  • Fonction : Auteur
R. Jerome
  • Fonction : Auteur
L. Romain
  • Fonction : Auteur
S. Marion
  • Fonction : Auteur
L. Sarah
  • Fonction : Auteur
R. Florian
  • Fonction : Auteur
B. Maximilien
  • Fonction : Auteur
A. Jeremie
  • Fonction : Auteur
A. Belle
  • Fonction : Auteur
L. Hugo
  • Fonction : Auteur
D. Martin
  • Fonction : Auteur
T. Ponchon
  • Fonction : Auteur

Résumé

Aims Last ESGE guidelines supposed that endoscopic peacemeal resection (P-EMR) are less impacting the environment than endoscopic submucosal dissection (ESD) for colonic adenoma’s resection. The prospective randomized multi centric RESECT study compared resection of colonic adenomas > 25 mm by P-EMR or ESD. In this post-hoc analysis we investigated the environmental impact of these procedures. Methods An independant eco-audit studied the two groups of RESECT colon on 4 parameters : endoscopes and disposable medical products, electricity consumed, anesthetic products, patient transport. We modeled 2 additional care organizations : ESD in expert hospital and P-EMR in local hospital. Results The calculated global environmental impact in the ESD RESECT group is 14614 eqkgCO2 against 20205 eqkgCO2 in the P-EMR RESECT group. If all P-EMR were performed in local hospital, the impact would be 11501 eqkgCO2 considering the same recurrence rate of 5% as in expert centers. Conclusions The ESD technique, which is discreetly more impactful in terms of the devices used but offers a curative treatment in a single session, reduces considerably the environmental impact by reducing the associated controls and transports. If P-EMR could be performed in a local center with the same level of quality, things would be more balanced. In the end, if a patient is referred to an expert center, then DSM should be chosen both for its efficiency results and for its reduced environmental impact. Ideally, DSM should be made available in the community.
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Dates et versions

hal-04568033 , version 1 (03-05-2024)

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Citer

R. Grau, P. Mathieu, P. Cottinet, J. Jacques, T. Wallenhorst, et al.. Environmental impact of endoscopic submucosal dissection versus piecemeal resection for large colonic adenomas : a post hoc analysis of the resect colon study. ESGE Days 2023, Apr 2023, Dublin, France. pp.S223, ⟨10.1055/s-0043-1765597⟩. ⟨hal-04568033⟩
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