Colorectal endoscopic submucosal dissection: Recent technical advances for safe and successful procedures

Area of Science:

• Gastroenterology
• Endoscopic Surgery

Background:

• Endoscopic submucosal dissection (ESD) enables en bloc resection of large superficial colorectal tumors.
• Colorectal ESD is technically demanding due to thin walls, poor maneuverability, and high perforation risk.

Purpose of the Study:

• To describe recent technical advances for safe and successful colorectal ESD.
• To highlight methods for improving mucosal flap creation, crucial for preventing complications.

Main Methods:

• Review of recent technical advances in colorectal ESD.
• Discussion of equipment, strategies, and novel procedures like the clip-flap method.

Main Results:

• Technical improvements facilitate mucosal flap creation, enhancing visualization and safety.
• Novel procedures appear to improve the safety and success rates of colorectal ESD.

Conclusions:

• Advances in techniques and training are essential for standardizing colorectal ESD globally.
• Improved methods for mucosal flap creation are key to safer and more successful colorectal ESD procedures.