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Case-Matched Analysis Comparing Endoscopic Submucosal Dissection and Surgical Removal of Difficult Colorectal Polyps
Tak Lit Derek Fung1, Pak Tat Chan1, Ha Man Lee1
1Department of Surgery, Queen Elizabeth Hospital , Hong Kong, China .
Introduction:
It is not uncommon to encounter colorectal polyps which could not be removed easily by simple polypectomy. Endoscopic submucosal dissection (ESD) has been a well-established method for doing so. We compared the result between ESD and surgical removal of these difficult colorectal polyps.
Materials And Method:
During the period between January 2013 and December 2016, patients who have failed endoscopic removal of colorectal polyp requiring second treatment, either by ESD or surgical removal, were matched into two groups and reviewed. Outcomes between two groups of patients, including complication rate, reintervention rate, length of stay, and readmission rate were studied.
Result:
A statistically significant difference in mean length of stay was observed. The length of stay was 4.2 days for ESD group and 8.7 days for surgery group (P < .001). There was significantly less than 30-day readmission in ESD group as well (0% versus 7.6%, P = .001). A higher complication rate was observed in surgery group (0% versus 18.4%, P < .001).
Conclusion:
ESD is a good method to remove colorectal polyps that are not suitable for endoscopic mucosal resection. When compared with traditional surgery, ESD had the benefit of shortening hospital stay and less postprocedure complication.
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