Endoscopic submucosal dissection for colorectal laterally spreading tumors

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Oncology

Background:

• Colorectal laterally spreading tumors (LSTs) are superficial neoplasms.
• LSTs are classified into granular (G-LST) and non-granular (NG-LST) types.
• Treatment decisions for LSTs depend on factors like size, histology, and location.

Purpose of the Study:

• To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) for treating colorectal LSTs.
• To compare outcomes between G-LSTs and NG-LSTs treated with ESD.
• To assess the rate of curative resection and complications associated with ESD for LSTs.

Main Methods:

• Retrospective analysis of 44 LSTs in 40 patients treated with ESD at a tertiary referral hospital.
• Data collected included tumor size, macroscopic type, location, histology, resection, and complications.
• Comparison of outcomes between G-LST and NG-LST groups.

Main Results:

• ESD was performed on 29 G-LSTs and 15 NG-LSTs.
• NG-LSTs were more common in the right colon, G-LSTs in the left colon (p<0.001).
• High curative resection rate (95.5%) and low complication rates (perforation 4.5%, major bleeding 2.3%, minor bleeding 6.8%) were observed.

Conclusions:

• Endoscopic submucosal dissection is a safe and effective treatment for early-stage malignant and pre-malignant colorectal LSTs.
• ESD achieves high curative rates for LSTs irrespective of lesion type or size.
• ESD is a viable alternative to surgery for selected LST patients.