Endoscopic submucosal dissection (ESD) for colorectal tumors.
BACKGROUND
Endoscopic submucosal dissection (ESD) is accepted as a minimally invasive treatment for early gastric cancer, however, it is not widely used in the colorectum because of its technical difficulty.


OBJECTIVE
To determine the feasibility of using ESD for treating large superficial colorectal tumors.


METHODS
A total of 400 consecutive patients were treated by ESD for 405 lesions at National Cancer Center Hospital, Tokyo, Japan.


METHODS
Endoscopic submucosal dissection procedures were performed using a bipolar needle knife (B-knife) or an insulation-tip knife (IT knife).


RESULTS
The en-bloc resection rate was 87% and the curative resection rate was 86% among the 405 ESDs: 101 involved tubular adenomas, 255 intramucosal cancers and minute submucosal cancers, 46 submucosal deep cancers and 3 others (MALT and carcinoid tumors). The median operation time was 90 minutes and the mean size of resected specimens was 40 mm (range: 15 mm-150 mm). Perforations occurred in 14 (3.5%) cases and postoperative bleeding in four (1%) cases, but only one perforation case needed emergency surgery because endoscopic clipping was ineffective.


CONCLUSIONS
Conducted at single center.


CONCLUSIONS
Endoscopic submucosal dissection is a feasible technique for treating large superficial colorectal tumors because it provides a higher en-bloc resection rate and is less invasive than surgical resection.
Saito
Yutaka
Y
National Cancer Center Hospital, Tokyo, Japan. ytsaito@ncc.go.jp
Sakamoto
Taku
T
Fukunaga
Shusei
S
Nakajima
Takeshi
T
Kiriyama
Shinsuke
S
Kuriyama
Shinsuke
S
Matsuda
Takahisa
T
D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000379:methods; D004210:Dissection / Q000379:methods; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D016896:Treatment Outcome