Related Experiment Video
Updated: Sep 11, 2025
ADSC-sheet Transplantation to Prevent Stricture after Extended Esophageal Endoscopic Submucosal Dissection
Published on: February 10, 2017
Submucosal fibrosis in large colorectal serrated lesions in cases receiving endoscopic submucosal dissection
Erik Manriquez-Alegria1,2, Naohisa Yoshida3, Reo Kobayashi1
1Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Background:
Submucosal fibrosis is a known risk factor for adverse outcomes in colorectal endoscopic submucosal dissection (ESD). However, evidence regarding the presence and impact of fibrosis in colorectal serrated lesions (CSLs) remains limited.
Objectives:
This study aimed to evaluate the association between CSLs and submucosal fibrosis, and to assess the impact of fibrosis presence on therapeutic outcomes of colorectal ESD.
Design:
Retrospective cohort study.
Methods:
We retrospectively reviewed consecutive colorectal ESD cases performed between 2020 and 2024. Only lesions ⩾20 mm were included; cases were classified as CSLs and adenoma + T1 cancer according to histological diagnosis. CSLs included sessile serrated lesions (SSL), traditional serrated adenomas, SSL with dysplasia, and unclassified serrated adenomas. Patient/lesion characteristics, presence of fibrosis, severe fibrosis, and ESD outcomes were assessed. Multivariate analyses, including CSLs' histology, were performed to identify factors associated with the presence of submucosal fibrosis and severe fibrosis.
Results:
A total of 445 colorectal ESD cases were included, comprising 72 CSLs and 373 adenoma + T1 cancer. CSLs were significantly associated with a lower presence of fibrosis (34.7% and 48.5%, p = 0.04) and severe fibrosis (6.9% vs 18.2%; p = 0.03) compared to adenoma + T1 cancer. In multivariate analysis, CSLs' histology (odds ratio (OR): 0.58; p = 0.04), lesion size ⩾40 mm (OR: 2.03; p < 0.01), and rectal location (OR: 0.40; p < 0.01) were significantly related to fibrosis presence. Lesion size ⩾40 mm (OR: 2.45; p < 0.01) and polypoid morphology (OR: 3.42; p < 0.01) were significantly related to severe fibrosis.
Conclusion:
CSLs' histology was negatively correlated with submucosal fibrosis in colorectal ESD.
More Related Videos
15:49Flexible Colonoscopy in Mice to Evaluate the Severity of Colitis and Colorectal Tumors Using a Validated Endoscopic Scoring System
Published on: October 16, 2013
09:42Murine Endoscopy for In Vivo Multimodal Imaging of Carcinogenesis and Assessment of Intestinal Wound Healing and Inflammation
Published on: August 26, 2014
Related Concept Videos
01:26Histology of the Large Intestine
The innermost mucosa layer comprises simple columnar epithelium, lamina propria, and muscularis mucosae. This layer is primarily populated with absorptive cells, tasked with water absorption, and goblet cells, responsible for secreting mucus to...
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
01:27Histology of the Small Intestine
The intestinal lining features transverse folds called circular folds, each housing fingerlike projections known as intestinal villi. These villi are covered by a layer of simple columnar epithelium, also referred to as...