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Updated: May 22, 2026

The Pocket-Creation Procedure of Endoscopic Submucosal Dissection for Large Rectal Laterally Spreading Tumors
Published on: February 13, 2026
Current status of colorectal endoscopic submucosal dissection in Japan and other Asian countries: progressing towards
Yutaka Saito1, Hiroshi Kawano, Yoji Takeuchi
1National Cancer Center Hospital, Tokyo, Japan. ytsaito@ncc.go.jp
Aim:
The primary purpose of this questionnaire survey study was to determine the current status of colorectal endoscopic submucosal dissection (ESD) in specialized Japanese referral centers before and after introduction of a government-approved advanced medical treatment system; and, secondly, to determine the current status of colorectal ESD in other Asian specialized referral centers.
Methods:
A total of 1321 colorectal ESDs were performed in 11 institutions including two Asian centers outside Japan.
Results:
Overall en-bloc resection, curative resection, R0 resection, perforation, delayed bleeding and emergency surgery rates were 95.4%, 89.1%, 87.2%, 2.9%, 2.5% and 0.2%, respectively. Similar clinical results were reported in the two Asian centers.
Conclusion:
There were no significant differences with regards to clinical results between the two periods although the perforation rate decreased from 3.3% to 2.4%. In addition, colorectal ESD has become increasingly standardized technically at specialized referral centers not only in Japan, but several other Asian referral institutions as well.
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