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Updated: May 8, 2026
The Pocket-Creation Procedure of Endoscopic Submucosal Dissection for Large Rectal Laterally Spreading Tumors
Published on: February 13, 2026
Clinical impact of endoscopic devices for colorectal endoscopic submucosal dissection
Asuka Harada1, Takuji Gotoda, Masakatsu Fukuzawa
1Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
Background/Aims:
Endoscopic submucosal dissection (ESD) allows the en bloc resection of large colorectal tumors. This requires a safe and effective ESD instrument. We compared colorectal ESD outcome using a bipolar or monopolar knife.
Methods:
We retrospectively studied 122 patients and 125 lesions in consecutive cases treated at our hospital. Patients were divided into a bipolar knife group (BKG; n = 45) and a monopolar knife group (MKG; n = 80). Comparisons were based on age and gender, tumor morphology, size and location, specimen size, procedure time, complications, and en bloc resection and curative resection rates.
Results:
There were no significant differences in age and gender, tumor morphology, size and location, or specimen size between the 2 groups. The procedure time was significantly shorter in the MKG than in the BKG (p < 0.05). The number of patients for whom the procedure time exceeded 120 min was significantly lower in the MKG than in the BKG (p < 0.05).
Conclusions:
In this study, the monopolar knife was shown to be effective for colorectal ESD with a shorter procedure time.
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