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Related Concept Videos

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy

Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...

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Related Experiment Video

Updated: Jun 20, 2026

The Pocket-Creation Procedure of Endoscopic Submucosal Dissection for Large Rectal Laterally Spreading Tumors
04:09

The Pocket-Creation Procedure of Endoscopic Submucosal Dissection for Large Rectal Laterally Spreading Tumors

Published on: February 13, 2026

Endoscopic submucosal dissection for colorectal tumors.

H Iizuka1, S Okamura, Y Onozato

  • 1Center of Gastroenterology, Maebashi Red Cross Hospital, Maebashi, Gunma, Japan.

Gastroenterologie Clinique Et Biologique
|September 19, 2009
PubMed
Summary

Endoscopic submucosal dissection (ESD) is better for large colorectal tumors, while endoscopic mucosal resection (EMR) is effective for smaller ones. Choosing between ESD and EMR requires careful lesion evaluation and risk-benefit assessment.

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Area of Science:

  • Gastroenterology
  • Endoscopic Surgery
  • Oncology

Background:

  • Endoscopic submucosal dissection (ESD) allows resection of larger colorectal tumors than conventional endoscopic mucosal resection (EMR).
  • The distinct roles of ESD and EMR in treating colorectal tumors require clarification.

Purpose of the Study:

  • To compare the indications and outcomes of ESD and EMR for colorectal tumors.
  • To determine the optimal endoscopic resection technique based on tumor characteristics.

Main Methods:

  • Retrospective analysis of colorectal tumors treated with ESD (44 tumors) and EMR (512 tumors).
  • Comparison of resection rates, including one-piece resection (OPR) and complete resection (CR), between ESD and EMR.
  • Identification of risk factors associated with incomplete resection.

Main Results:

  • EMR was primarily used for adenomas <20 mm, achieving high OPR and CR rates.
  • For tumors ≥20 mm, especially those with cancer or laterally spreading types, ESD demonstrated a significantly higher CR rate (0% positive lateral margin) compared to EMR (16% positive lateral margin).
  • ESD procedures were longer and had a higher perforation risk, with 7 cases aborted due to technical issues or perforation.

Conclusions:

  • ESD and EMR possess distinct characteristics for colorectal tumor treatment.
  • Selection of ESD or EMR should be based on a thorough evaluation of the lesion and a careful balance of potential benefits and risks.