Clinical application of tunnel technique on endoscopic submucosal dissection for colorectal laterally spreading tumor

Abstract

Objective To investigate the clinic effect of tunnel technique on endoscopic submucosal dissection (ESD) for massive colorectal laterally spreading tumor (LST). Methods A retrospective study was conducted on the data of patients with colorectal large area LST (the shortest diameter>4 cm) undergoing ESD by tunnel technique from January 2015 to June 2016 in Digestive Endoscopy Center of Jiangsu Province Hospital of Traditional Chinese Medicine. The size of resected specimens, operation time, complications, pathology results, the number of en bloc resection and curative resection were analyzed. Results A total of 14 cases were collected, including 7 males and 7 females. The longest diameters of resected specimens were from 4.0 to 7.0 cm with mean size of 5.18±0.49 cm. The operation times were from 40 to 120 min with mean time of 63.57±12.95 min. Intraoperative perforation occurred in 2 cases but no delayed perforation and bleeding occurred. Postoperative pathology showed 1 patient with adenoma hyperplasia with crypt abscess, 3 patients with low grade intraepithelial neoplasia, 6 patients with high grade intraepithelial neophasia, 1 patient with carcinoma in situ, 1 patient with carcinoma in M3, and 2 patients with carcinoma in SM1. The number of cases who received en bloc resection, complete resection, and curative resection were 13, 13, and 13, respectively. Conclusion ESD by tunnel technique is safe and effective in the treatment of colorectal large area LST, which is worth popularizing in clinics. Key words: Therapeutic endoscopy; Endoscopic submucosal dissection; Tunnel technique; Colorectal laterally spreading tumor