The Efficacy and Safety of Endoscopic Submucosal Dissection in Colorectal Neoplasms: Single Center Study.
- Author:
Hye Jin SEO
1
;
Kwang Bum CHO
;
Seok Guen LEE
;
Hong Seok LEE
;
Eun Soo KIM
;
Byoung Kuk JANG
;
Kyung Sik PARK
;
Woo Jin CHUNG
;
Jae Seok HWANG
Author Information
1. Department of Internal Medicine, Keimyung University College of Medicine, Daegu, Korea. chokb@dsmc.or.kr
- Publication Type:Original Article
- Keywords:
Endoscopic submucosal dissection;
Colorectal neoplasm;
En bloc resection
- MeSH:
Adenoma;
Colorectal Neoplasms;
Hemorrhage;
Humans;
Neoplasms, Glandular and Epithelial;
Retrospective Studies
- From:Korean Journal of Gastrointestinal Endoscopy
2009;39(3):136-142
- CountryRepublic of Korea
- Language:Korean
-
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.
