P2790 - Recovery and Functional Results Following Endoscopic Intramuscular Dissection for Invasive Rectal Carcinomas

Drumadala Gajbhiye, MBBS¹, Kashif Ali, MD², Azouba Gulraiz, MD³, Usama B. Shabbir, MD⁴, Muhammad Hassan Cheema, MD⁵, Muhammad Hussnain Cheema, MD⁵, Aeman Zafar, MBBS⁵, Noor Fatima, MBBS⁵, Alamdar Hussain, MD⁵, Humais H. Choudhary, MBBS⁶, Hamza Saleem, MD⁵, Ghulam Mustafa, MBBS^7
1Government Medical College and Hospital, Akola, Maharashtra, India; ²University of Texas Rio Grande Valley, Edinburg, TX; ³Merit Health Wesley, Hattiesburg, MS; ⁴Services Institute of Medical Sciences, Lahore, Punjab, Pakistan; ⁵Nishtar Medical University, Multan, Punjab, Pakistan; ⁶Sahiwal Medical College, Sahiwal, Punjab, Pakistan; ⁷Dow University of Health Sciences, Karachi, Sindh, Pakistan

Introduction: Endoscopic intramuscular dissection (EID) is increasingly used in the treatment of invasive rectal carcinomas, with some patients requiring additional surgical intervention following the procedure. The effect of EID on post-procedure recovery and the incidence of surgical morbidity and mortality remains uncertain at present. Our study sought to evaluate the post-procedure recovery and 90-day morbidity and mortality following EID for invasive rectal carcinomas.

Methods: Patients diagnosed with invasive rectal cancers were included in the study, with exclusion criteria applied to those who had undergone neoadjuvant therapy. Information regarding post-procedural recovery, pain levels, and functional outcomes, assessed using a validated Low Anterior Resection Syndrome (LARS) questionnaire, was gathered through on-site surveys. Propensity score adjustment was employed to account for potential confounding variables.

Results: A total of 210 patients underwent endoscopic intramuscular dissection (EID). Among them, 112 patients (53.3%) underwent rectal preservation, including 23 (11%) who received adjuvant chemoradiotherapy (CRT). Following EID, 189 patients (90%) were discharged in less than 24 hours, while 12 patients (5.7%) were readmitted due to pain, fever, or delayed bleeding. One patient (0.4%) required dilation for stenosis. Regarding pain management, 144 patients (69%) did not require analgesics, while 29 patients (13.8%) experienced significant pain necessitating analgesics for 7 days or more, including opioids. Major Low Anterior Resection Syndrome (LARS) incidence after EID alone was 6.3%.

Discussion: Our study concludes that endoscopic intramuscular dissection demonstrates safety with swift recovery and minimal risk of severe complications or enduring bowel dysfunction. Expectation of post-procedural pain is advisable for lesions located in the lower rectum.


Disclosures:


Drumadala Gajbhiye, MBBS¹, Kashif Ali, MD², Azouba Gulraiz, MD³, Usama B. Shabbir, MD⁴, Muhammad Hassan Cheema, MD⁵, Muhammad Hussnain Cheema, MD⁵, Aeman Zafar, MBBS⁵, Noor Fatima, MBBS⁵, Alamdar Hussain, MD⁵, Humais H. Choudhary, MBBS⁶, Hamza Saleem, MD⁵, Ghulam Mustafa, MBBS⁷. P2790 - Recovery and Functional Results Following Endoscopic Intramuscular Dissection for Invasive Rectal Carcinomas, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.