Endoscopic submucosal dissection (ESD) for colorectal tumors

Area of Science:

• Gastroenterology
• Surgical Oncology
• Minimally Invasive Procedures

Background:

• Endoscopic submucosal dissection (ESD) is established for early gastric cancer.
• Its application in colorectal settings is limited due to technical challenges.

Purpose of the Study:

• To assess the feasibility of ESD for large, superficial colorectal tumors.
• To evaluate ESD's efficacy and safety in this patient cohort.

Main Methods:

• A single-center study involving 400 patients and 405 colorectal lesions.
• Procedures utilized bipolar needle knife or insulation-tip knife.
• Lesions included adenomas, intramucosal/submucosal cancers, and other tumor types.

Main Results:

• Achieved an 87% en-bloc resection rate and an 86% curative resection rate.
• Median operation time was 90 minutes; mean resected specimen size was 40 mm.
• Reported a 3.5% perforation rate and 1% bleeding rate, with minimal need for surgery.

Conclusions:

• ESD is a viable and effective endoscopic treatment for large superficial colorectal tumors.
• Offers superior en-bloc resection rates compared to traditional surgery.
• Represents a less invasive therapeutic option for colorectal neoplasia.