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Optimized hybrid endoscopic submucosal dissection for colorectal tumors: a randomized controlled trial
Jung Ho Bae1, Dong-Hoon Yang1, Seungyun Lee1
1Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Gastrointestinal Endoscopy
|September 1, 2015
Summary
Optimized hybrid endoscopic submucosal dissection (ESD) significantly reduces colorectal procedure times compared to standard ESD. This technique offers similar en bloc resection and safety rates, presenting a viable alternative and rescue method.
Area of Science:
- Gastroenterology
- Endoscopic Surgery
- Oncology
Background:
- Colorectal endoscopic submucosal dissection (ESD) is technically challenging and lengthy.
- Optimized hybrid ESD, incorporating snaring, aims to improve efficiency.
Purpose of the Study:
- To prospectively compare the efficacy and safety of standard ESD versus optimized hybrid ESD for colorectal neoplasia.
- To evaluate procedure time, en bloc resection, complete resection, and adverse event rates.
Main Methods:
- A prospective randomized trial involving 70 patients with colorectal neoplasia ≥20 mm.
- Patients were randomized to either standard ESD (36) or optimized hybrid ESD (34).
- Optimized hybrid ESD involved snare resection after submucosal dissection.
Main Results:
- Mean procedure time was significantly shorter for optimized hybrid ESD (27.4 min) versus ESD (40.6 min; P=.005).
- En bloc resection rates were similar (94.1% vs 100%; P=.493).
- Complete resection rates (91.2% vs 93.5%) and perforation rates (8.8% vs 6.5%) were comparable between groups.
Conclusions:
- Optimized hybrid ESD offers a shorter procedure time compared to standard ESD for colorectal lesions.
- The technique demonstrates comparable en bloc resection and adverse event rates.
- Optimized hybrid ESD is a potential alternative and rescue strategy for colorectal ESD.
