Factors for conversion risk of colorectal endoscopic submucosal dissection: a multicenter study

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Oncology

Background:

• Endoscopic submucosal dissection (ESD) is a standard treatment for colorectal tumors.
• Challenges persist, including incomplete resection and perforation risks.

Purpose of the Study:

• To identify risk factors for incomplete resection and perforation in standardized colorectal ESD.
• To analyze clinicopathologic and endoscopic characteristics associated with adverse events.

Main Methods:

• Multi-center study of 2592 colorectal ESD procedures across 11 institutions.
• Inclusion of 2423 consecutive patients from August 2013 to December 2018.
• Evaluation of risk factors for interruption, piecemeal resection, and perforation.

Main Results:

• Incidences: interruption (0.7%), piecemeal resection (2.9%), perforation (3.0%).
• Risk factors for interruption: perforation, deep submucosal invasion, poor scope operability, severe fibrosis.
• Risk factors for piecemeal resection: poor scope operability, fibrosis, long procedure time.
• Risk factors for perforation: fibrosis, poor scope operability, long procedure time, large tumor size.

Conclusions:

• Severe submucosal fibrosis and poor scope operability are common risk factors.
• These factors are associated with interruption, piecemeal resection, and perforation in colorectal ESD.