title: Endoscopic submucosal dissection for locally recurrent colorectal lesions after previous endoscopic mucosal resection.
abstract: OBJECTIVE
  The objective of this study was to determine the efficacy and safety of endoscopic submucosal dissection for locally recurrent colorectal cancer after previous endoscopic mucosal resection.
  
  
  METHODS
  A total of 16 patients with locally recurrent colorectal lesions were enrolled. A needle knife, an insulated-tip knife and a hook knife were used to resect the lesion along the submucosa. The rate of the curative resection, procedure time, and incidence of complications were evaluated.
  
  
  RESULTS
  Of 16 lesions, 15 were completely resected with endoscopic submucosal dissection, yielding an en bloc resection rate of 93.8 percent. Histologic examination confirmed that lateral and basal margins were cancer-free in 14 patients (87.5 percent). The average procedure time was 87.2 +/- 60.7 minutes. None of the patients had immediate or delayed bleeding during or after endoscopic submucosal dissection. Perforation in one patient (6.3 percent) was the only complication and was managed conservatively. The mean follow-up period was 15.5 +/- 6.8 months; none of the patients experienced lesion residue or recurrence.
  
  
  CONCLUSIONS
  Endoscopic submucosal dissection appears to be effective for locally recurrent colorectal cancer after previous endoscopic mucosal resection, making it possible to resect whole lesions and provide precise histologic information.
authors.affiliation: Endoscopy Center, Zhongshan Hospital, Fudan University, Shanghai, China. zhou1968@yahoo.cn
authors.forename: Pinghong
authors.initials: P
authors.lastname: Zhou
authors.forename: Liqing
authors.initials: L
authors.lastname: Yao
authors.forename: Xinyu
authors.initials: X
authors.lastname: Qin
authors.forename: Meidong
authors.initials: M
authors.lastname: Xu
authors.forename: Yunshi
authors.initials: Y
authors.lastname: Zhong
authors.forename: Weifeng
authors.initials: W
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D020685:Colonoscopes; D003113:Colonoscopy / Q000009:adverse effects / Q000379:methods; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D012086:Reoperation