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Updated: Jun 23, 2025

E-Patient Counseling Trial E-PACO: Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy

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Hybrid Versus Conventional Colorectal Endoscopic Submucosal Dissection: A Multicenter Randomized Controlled Trial

Dennis Yang¹, Muhammad K Hasan¹, Salmaan Jawaid²

¹Center for Interventional Endoscopy, AdventHealth, Orlando, Florida, USA.

The American Journal of Gastroenterology

|June 24, 2024

Summary

This summary is machine-generated.

Hybrid endoscopic submucosal dissection (H-ESD) offers a faster procedure time for large colorectal lesions compared to conventional ESD (C-ESD). Both methods are safe and effective, with H-ESD showing potential as a viable alternative.

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Published on: October 16, 2013

Area of Science:

Gastroenterology
Endoscopy
Surgical Techniques

Background:

Conventional endoscopic submucosal dissection (C-ESD) presents technical challenges for large colorectal lesions.
Hybrid endoscopic submucosal dissection (H-ESD) combines ESD knife and snare resection to simplify the procedure.

Purpose of the Study:

To compare the therapeutic outcomes of H-ESD versus C-ESD for non-pedunculated colorectal lesions measuring ≥20 mm.
To evaluate procedure time, en bloc resection rates, complete resection rates, and adverse events.

Main Methods:

A multicenter randomized controlled trial (Short-ESD trial) was conducted.
Patients with colorectal lesions (20-50 mm) were randomized to H-ESD or C-ESD.
Primary outcome: procedure time; Secondary outcomes: resection rates and adverse events.

Main Results:

Mean procedure time was significantly shorter for H-ESD (41.1 min) than C-ESD (54.3 min) (P=0.007).
En bloc and complete (R0) resection rates trended lower in H-ESD but were not statistically significant (77.5% vs 87.8% and 72.5% vs 79.6%).
Adverse event rates were similar between H-ESD (10%) and C-ESD (8.2%).

Conclusions:

Both H-ESD and C-ESD are safe and effective for large colorectal lesion resection.
H-ESD offers a significant advantage in reduced procedure time.
H-ESD is a viable alternative to C-ESD, particularly for colorectal lesions, due to its easier applicability.