Clinical study of endoscopic multiband mucosectomy and endoscopic submucosal dissection in the treatment of colorectal submucosal tumors under the guidance of ultrasound endoscopy

Abstract

Objective To explore the therapeutic effect and safety of endoscopic multi-band mucosetomy (EMBM) and endoscopic submucosal dissection(ESD) for colorectal submucosal tumors under the guidance of ultrasound endoscopy. Methods From January 2013 to June 2016, the clinical data of sixty patients with colorectal submucosal tumors in Center People's Hospital of Tengzhou who received either EMBM (32 cases) or ESD (28 cases) were included in this retrospective study.The complete resection rate, average diameter of resection lesion, operative time, complications and recurrence rate of two groups were compared. Results The complete resection rate of EMBM groups was 96.9%(31/32), the complete resection rate of ESD groups was 96.4%(27/28), there was no statistically significant difference between the two groups(χ2=0.07, P=0.812). The average diameter of was ESD group (12.3±2.6) mm, significantly greater than that of EMBM group ((9.1±2.2) mm) (P=0.038), and the mean operation time of EMBM group was (20.5±5.1) min, which was significantly less than that of ESD group ( (36.8±4.5) min) (P=0.008), and the percentage of perforation in EMBM group was 0, significantly lower than that of ESD group (10.7%(3/28))( χ2=6.37, P=0.013). The severe bleeding rate of EMBM group was 3.1% (1/32), which was significantly lower than that in ESD group(14.3%(4/28))(χ2=4.89, P=0.021). After 6-12 months of follow-up, no recurrence or distant metastasis was found in EMBM or ESD group. Conclusion EMBM and ESD are safe and effective for colorectal submucosal tumors, However the average diameter of the lesion was larger in EMBM group than that in ESD group. Key words: Colorectal submucosal tumor; Endoscopic ultrasonography; Endoscopic multiband mucosectomy; Endoscopic submucosal dissection