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Updated: Jul 10, 2026
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The Pocket-Creation Procedure of Endoscopic Submucosal Dissection for Large Rectal Laterally Spreading Tumors
Published on: February 13, 2026
Achieving R0 resection in the colorectum using endoscopic submucosal dissection.
D P Hurlstone1, R Atkinson, D S Sanders
1Gastroenterology and Liver Unit, Royal Hallamshire Hospital, Sheffield, UK. p.hurlstone@shef.ac.uk
The British Journal of Surgery
|October 24, 2007
Summary
Endoscopic submucosal dissection (ESD) effectively removes large colorectal tumors, achieving high R0 resection and cure rates. This technique is safe and feasible for selected lesions, offering a viable treatment option.
Area of Science:
- Gastroenterology
- Endoscopic Surgery
- Oncology
Background:
- Endoscopic mucosal resection (EMR) is limited to colorectal tumors <20 mm.
- Endoscopic submucosal dissection (ESD) allows en bloc resection of larger lesions (>20 mm).
Purpose of the Study:
- To assess the feasibility, safety, and efficacy of ESD for colorectal tumors in a UK prospective study.
- To evaluate R0 resection, complication rates, and recurrence after ESD.
Main Methods:
- Prospective study of patients with Paris 0-II adenomas or laterally spreading tumors (LSTs) >20 mm.
- Lesions assessed by chromoscopy and ultrasonography; outcomes recorded.
Main Results:
- ESD performed in 42 patients; en bloc resection in 33.
- R0 resection achieved in 74% (31/42 patients).
- 6-month cure rate was 81% (34/42 patients); 0% mortality, low complication rates (1 perforation, 5 bleeding).
Conclusions:
- ESD is a feasible and effective treatment for large colorectal adenomas and LSTs.
- High R0 resection and cure rates are achievable with ESD.
- Consider ESD for selected T1 N0 colorectal lesions.
