A retrospective study of endoscopic submucosal dissection for colorectal tumors

Abstract

Objective To investigate the clinical efficacy of endoscopic submucosal dissection (ESD) for the treatment of colorectal tumors, and to analyze risk factors affecting operation time. Methods A retrospective study was conducted using data of 74 cases with colorectal tumor, who underwent ESD in Department of Gastroenterology of Wuhan University Renmin Hospital from January 2014 to September 2015. The clinical efficacy of ESD, occurrence of complications and follow-up results were summarized, and the risk factors of operation time were analyzed. Results The rate of ESD en bloc resection and histological complete resection was 97.30% (72/74) and 89.19% (66/74), respectively. Among the 8 cases of histological non-curative resection, 2 cases received appended surgical procedures because of deep invasion of tumor (SM2), 6 cases were given close follow-up according to the pathological result of adenomas. Among the 74 cases, no acute hemorrhage or pneumoperitoneum occurred. Four cases (5.41%, 4/74) had postoperative delayed bleeding, and were successfully treated by endoscopic hemostasis. Four cases (5.41%, 4/74) had intraoperative perforation, and were successfully treated by endoscope. No recurrence or abnormal lesions occurred during the follow-up of 15-35 months. Multivariate linear regression analysis showed that tumor size was a main risk factor for ESD operation time (P=0.000). Conclusion ESD, as a minimally invasive treatment, is safe and effective for the treatment of colorectal tumors, and the tumor size is a main risk factor of ESD operation time. Key words: Colorectal tumors; Endoscopic therapy; Endoscopic submucosal dissection; Complication; Operation time