Predictive factors for technically difficult endoscopic submucosal dissection in large colorectal tumors

Area of Science:

• Gastroenterology
• Surgical Endoscopy
• Oncology

Background:

• Endoscopic submucosal dissection (ESD) is a complex procedure for large colorectal tumors.
• Technical difficulties and risks associated with large colorectal tumor ESD are not well-documented.

Purpose of the Study:

• To investigate factors predicting technical difficulty in endoscopic submucosal dissection (ESD) for large colorectal tumors.
• To identify risk factors for complications during ESD of large colorectal tumors.

Main Methods:

• Retrospective analysis of 36 large colorectal tumors treated with ESD between October 2012 and January 2015.
• Evaluation of five factors to predict technical difficulty and complications.

Main Results:

• En bloc resection rate was 83.33%, with R0 and curative resection rates of 80.56% and 77.78%, respectively.
• Tumor location in a flexure was a significant risk factor for perforation, non-en bloc resection, and slower dissection speed.
• Increased tumor size correlated with a higher perforation rate.

Conclusions:

• ESD for large colorectal tumors is technically more demanding in colonic flexures.
• Effective perforation closure techniques are crucial for managing large tumor resections.
• Findings can guide endoscopists in performing ESD for large colorectal tumors safely.