Endoscopic submucosal dissection for colorectal polyps: outcome determining factors

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Oncology

Background:

• Endoscopic submucosal dissection (ESD) is increasingly used for complex colorectal polyps.
• Clinical outcomes of ESD for colorectal polyps are inconsistent globally.
• Identifying factors influencing ESD outcomes is crucial for improving patient care.

Purpose of the Study:

• To investigate and analyze factors significantly affecting outcomes of endoscopic submucosal dissection (ESD) for colorectal polyps.
• To identify predictors of successful resection and complications in ESD procedures.
• To provide data for developing strategies to enhance ESD efficacy.

Main Methods:

• A retrospective study of 220 colorectal polyps treated with ESD between January 2016 and December 2020.
• Data collected included patient demographics, ESD technical details, and polyp characteristics.
• Primary outcomes were en bloc and R0 resection rates; secondary outcomes included recurrence, complications, and hospital stay.

Main Results:

• En bloc and R0 resection rates were 97.3% and 65%, respectively.
• Submucosal fibrosis was linked to lower resection rates, increased perforation, bleeding, and post-polypectomy syndrome.
• Hybrid snaring, longer ESD duration, younger age, and larger polyp size were also associated with adverse outcomes.

Conclusions:

• Submucosal fibrosis, hybrid snaring technique, procedure duration, patient age, and polyp size are significant factors influencing ESD outcomes.
• Understanding these factors can guide the development of improved strategies for endoscopic submucosal dissection.
• Targeted interventions based on identified risk factors may enhance the success and safety of ESD for colorectal polyps.