Endoscopic submucosal dissection for early large low rectal carcinomas and its precancerous lesions

Abstract

Objective To evaluate the therapeutic value of endoscopic submucosal dissection （ESD） for early large low rectal carcinomas and its precancerous lesions. Methods The clinical data, pathology, complications and follow-up results of 24 cases of early large low rectal carcinomas and precancer- ous lesion, which were larger than 5em in diameter and treated by ESD, were retrospectively analyzed. Results The mean diameter of the lesions was 5.54 （5-7）cm, and the mean procedure time was 85 （45- 180）rain. The en bloc resection rate was 91.7% （22/24）, and histologically en bloc resection rate was 83.3% （20/24）. With regard to complication, 3 cases of postoperative hemorrhage （12. 5% ） and 2 cases of perforation （8. 3% ） were recorded, and no local reeurrenee or metastasis was Observed during＇the follow- up of 16-47 months. Conclusion ESD is effective for the treatment of large nonpeduneulated low rectal tumors. The ESD procedure facilitates a more precise pathologic diagnosis and reduees recurrence through en bloc resection, which also retains the function of the anus. Key words: Rectal cancer; Precancerous lesion; Endoscopic submucosal dissection