title: Usefulness and feasibility of endoscopic submucosal dissection for colorectal tumor: a nationwide multicenter retrospective study in Korea.
abstract: BACKGROUND
  Detection rate of precursor lesion of colorectal cancer and early colon cancer have recently been rising because of increased screening endoscopy and increased incidence of colorectal cancer. Endoscopic submucosal dissection (ESD) technique has been reported to be useful in the treatment of such superficial lesions in colon. However, nationwide multicenter study for usefulness and feasibility of colorectal ESD is still limited.
  
  
  METHODS
  From January 2009 to February 2014, colorectal ESD data performed at nationwide university hospitals were enrolled in retrospective design. Demographic, clinical, technical data, and data of complications were reviewed.
  
  
  RESULTS
  A total of 189 patients were included with 191 lesions resected by colorectal ESD. The indications were epithelial lesions (n=120), neuroendocrine tumor (n=25), cancer (n=46). The lesion locations were right colon (n=45), transverse colon (n=17), descending colon (n=8), sigmoid colon (n=33), rectum (n=88). The median size of the lesions was 21.1 mm. En bloc resection rate of the lesion was 83.3%, with complete R0 resection in 73.3%. The median duration of ESD was 53.7 minutes. Factor related to En bloc resection was tumor location (right colon/transverse colon 72.6%vs.other location 89.2%, P=0.004). Factors related complication were tumor location (right colon/transverse colon 12.9%vs.Other location 10.13%, P=0.044) and tumor size (without complication 20.5±10.2 mmvs.with complication 25.9±11.7 mm, P=0.027). The short term morbidity rate was 11.0% including 5 hemorrhages (2.6%) and 16 perforations (8.4%).
  
  
  CONCLUSIONS
  In this study, ESD shows promise as a useful, potentially feasible procedure in colorectal superficial tumor because of high en bloc resection rate and low morbidity rate, especially in small lesions located from descending colon to rectum.
authors.affiliation: Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea.
authors.forename: Ji Hye
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Kyung Hee University Hospital at Gangdong, Kyung Hee University, Seoul, Korea.
authors.forename: Il Hyun
authors.initials: IH
authors.lastname: Baek
authors.affiliation: Gachon University Gil Hospital, Gachon Graduate School of Medicine, Incheon, Korea.
authors.forename: Kyoung Oh
authors.initials: KO
authors.lastname: Kim
authors.affiliation: Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea.
authors.forename: Hyun Joo
authors.initials: HJ
authors.lastname: Jang
authors.affiliation: Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea.
authors.forename: Gwang Ho
authors.initials: GH
authors.lastname: Baik
authors.affiliation: Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Chang Kyun
authors.initials: CK
authors.lastname: Lee
authors.affiliation: Graduate School of Chung-Ang University, Seoul, Korea.
authors.forename: Kyeong Won
authors.initials: KW
authors.lastname: Min
keywords: Endoscopic submucosal dissection (ESD); colorectal superficial tumor; distal colon