Is endoscopic submucosal dissection really contraindicated for a large submucosal lipoma of the colon?

Abstract

Endoscopic submucosal dissection (ESD) has recently been developed for endoscopic treatment of gastrointestinal tumors, enabling en bloc resection of even large tumors [1] [2]. Although many endoscopists now perform ESD for early-stage gastric cancer, ESD has yet to be established as a safe therapy for colonic diseases, even in Japan. It is still unclear whether ESD is indicated for submucosal tumors (SMTs), and ESD for colonic diseases is still a controversial issue due to the considerable risk of perforation. In the pre-ESD era, SMTs required surgical treatment. Here we describe a unique case of a large submucosal lipoma of the colon which was successfully resected en bloc by ESD.