The Efficacy and Safety of Endoscopic Submucosal Dissection in Colorectal Neoplasms: Single Center Study

Seo, Hye Jin; Cho, Kwang Bum; Lee, Seok Guen; Lee, Hong Seok; Kim, Eun Soo; Jang, Byoung Kuk; Park, Kyung Sik; Chung, Woo Jin; Hwang, Jae Seok

Abstract

BACKGROUND/AIMS
Endoscopic submucosal dissection (ESD) is not commonly used in the colorectal area because of technical difficulty and due to the characteristics of the organ. We therefore wanted to determine the efficacy and safety of endoscopic submucosal dissection in colorectal neoplasms.
METHODS
Colorectal tumor lesions resected by ESD in a single medical center were analyzed retrospectively.
RESULTS
A total of 47 patients were treated for 50 lesions. Mean age was 64.3+/-9.8 (43~85) years. Laterally spreading tumors were the most common type (44, 88%) followed by Is+IIa type tumors (6, 12%). The en bloc resection rate was 76% and the complete resection rate was 74%. The mean procedure time was 81.1+/-44.7 (20~180) minutes. The mean size of resected specimen was 26.9+/-10.4 (10~50) mm. The histological diagnosis determined that 24 lesions (48%) were tubular adenoma, 18 lesions (36%) were intramucosal cancer, 7 lesions (14%) were sm1 cancer and 1 lesion (2%) was over sm2 cancer. Bleeding occurred in 6 (12%) and perforations in 13 (26%) of the patients and all were treated successfully by endoscopic or conservative treatment. The concordance rate of pre and post ESD pathological diagnosis was only 47%.
CONCLUSIONS
ESD is a feasible technique for treating superficial colorectal tumors with a high complete resection rate, minor invasiveness, and a high safety rate. In addition, ESD might be useful in establishing the complete pathological evaluation of colorectal epithelial neoplasm.