Case-Matched Analysis Comparing Endoscopic Submucosal Dissection and Surgical Removal of Difficult Colorectal Polyps

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Colorectal Surgery

Background:

• Difficult-to-remove colorectal polyps often require advanced endoscopic or surgical intervention.
• Endoscopic submucosal dissection (ESD) is an established technique for complex polyp removal.
• This study compares ESD with surgical removal for challenging colorectal polyps.

Purpose of the Study:

• To compare the outcomes of endoscopic submucosal dissection (ESD) versus surgical removal for colorectal polyps.
• To evaluate complication rates, reintervention, length of stay, and readmission for both procedures.

Main Methods:

• A retrospective review of patients treated between January 2013 and December 2016.
• Patients who failed initial endoscopic removal and underwent either ESD or surgery were matched into two groups.
• Key outcomes including complication rate, reintervention rate, length of stay, and readmission rate were analyzed.

Main Results:

• Endoscopic submucosal dissection (ESD) resulted in a significantly shorter length of stay (4.2 days vs. 8.7 days).
• The ESD group showed significantly lower 30-day readmission rates (0% vs. 7.6%).
• Surgical removal was associated with a higher complication rate (18.4% vs. 0% for ESD).

Conclusions:

• Endoscopic submucosal dissection (ESD) is an effective method for removing colorectal polyps unsuitable for simpler endoscopic resection.
• Compared to traditional surgery, ESD offers benefits such as reduced hospital stay and fewer post-procedure complications.
• ESD presents a favorable alternative for managing difficult colorectal polyps, improving patient outcomes.