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Evaluation of the Effectiveness of Longitudinal Incision for Endoscopic Submucosal Excavation of Gastric Subepithelial Lesions
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Endoscopic Intermuscular Dissection - Short-term Outcomes.

Lisa Birzle1, Alanna Ebigbo2, Sandra Nagl1

  • 1Department of GastroenterologyUniversity Hospital AugsburgAugsburgBavariaGermany.

Endoscopy International Open
|June 25, 2026
PubMed
Summary
This summary is machine-generated.

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Endoscopic intermuscular dissection (EID) is a feasible technique for resecting deep submucosal invasive T1 rectal cancers. This organ-preserving approach shows promise for early rectal cancer treatment, though further research is needed.

Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Minimally Invasive Surgery

Background:

  • Early rectal cancer management often involves risk stratification for tailored treatment.
  • Deep submucosal invasive T1 rectal cancers present a challenge for organ preservation.
  • Endoscopic intermuscular dissection (EID) is an emerging technique for rectal lesion resection.

Purpose of the Study:

  • To evaluate the feasibility and outcomes of endoscopic intermuscular dissection (EID).
  • To assess the potential role of EID in risk-adapted treatment strategies for early rectal cancer.
  • To present a case series of patients undergoing EID for suspected deep submucosal invasive T1 rectal cancers.

Main Methods:

  • EID was performed in 16 patients with suspected deep submucosal invasive T1 rectal cancers.
Keywords:
colorectal cancerdiagnosis and imaging (inc chromoendoscopy, NBI, iSCAN, FICE, CLE, ...)endoscopic resection (polypectomy, ESD, EMRc, ...)endoscopy lower GI tract

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  • En bloc resection was achieved in all cases.
  • Resection site closure was performed using a hand-suturing device in six patients.

    • Main Results:

    • All lesions were resected en bloc without major complications.
    • Histopathology confirmed various stages of rectal cancer and adenomas.
    • Fourteen resections had clear margins; R1 margins were noted in two cases, managed appropriately.

    Conclusions:

    • Endoscopic intermuscular dissection (EID) is a feasible and promising approach for managing rectal deep submucosal invasive cancers.
    • EID may serve as an organ-preserving alternative to radical surgery for selected patients.
    • Further data are required to refine patient selection and solidify EID's role in early rectal cancer treatment.