Comparison between endoscopic submucosal dissection and transanal endoscopic microsurgery for the treatment of rectal tumor

Abstract

Objective To compare the efficacy and safety between endoscopic submucosal dissection (ESD) and transanal endoscopic microsurgery (TEM) for the treatment of rectal tumors, including rectal adenoma, early rectal carcinoma, and rectal neuroendocrine tumors (NET). Methods We conducted an analysis including 139 patients with rectal tumors who underwent ESD (87) or TEM (52). The size of the tumor, location of the tumor, en bloc resection, R0 resection, procedure time, hospital stay, complications, etc, between the two groups were evaluated and analyzed. Results There was no significant difference in tumor size [(7.8±3.4) cm vs. (6.9±3.5) cm, P=0.398], location [(7.8±3.4) cm vs. (6.9±3.5) cm, P=0.320], en bloc resection (100% vs. 100%), R0 resection (94.3% vs. 100.0%, P=0.053), perforation rate (6.9% vs. 0%, P=0.053) and the recurrence of the same location (0% vs. 0%) between the two groups. Procedure time [(42.1±27.3) min vs. (78.5±21.3) min, P=0.018], the use of antibiotics (32.2% vs. 100%, P=0.000) and hospital stay [(6.3±4.8) days vs. (13.7±2.9) days, P=0.021] in the ESD group were significantly shorter than ESD group. The volume of intraoperative bleeding of the patients in the TEM group was less than that in ESD group [(53.0±18.7) ml vs. (31.7±12.4) ml, P=0.033]. Conclusion ESD is a safe and effective therapy for rectal tumors. Key words: Rectal tumors; Endoscopic submucosal dissection; Transanal endoscopic microsurgery