Therapeutic efficacy and safety of endoscopic submucosal dissection for early colorectal carcinoma and precancerous lesions

Abstract

Objective To evaluate the therapeutic effectiveness and safety of endoscopic submucosal dissection(ESD) for early colorectal carcinoma and its precancerous lesions. Methods The clinical pathological characteristics, en bloc resection rate, curative resection rate, complications and follow-up results of 21 patients with early colorectal carcinoma or precancerous lesions, who were treated by ESD, were retrospectively analyzed. Results Most lesions were located in left colon, which accounted for 80.9%(17/21). The most common macroscopic morphology(Type Ⅰ) was protrusion type (61.9%, 13/21), while flat type was the least(14.3%, 3/21). The mean procedure time was 79(35-120)min. The en blot resection rate was 100.0%(21/21), and curative resection rate was 85.7%(18/21). Postoperative hemorrhage occurred in 1 patient (4.7%, 1/21) and postoperative infection occurred in 1(4.7%, 1/21) and no perforation was recorded. Tubular adenoma with high-grade intraepithelial neoplasia(LGIEN) was the most occurence(33.3%, 7/21), villous adenoma with LGIEN was the least (4.7%, 1/21). No local recurrence or metastasis was observed during follow-up of 3-20 months. Conclusion ESD is safe, effective, minimal invasive for early colorectal carcinoma and its precancerous lesions, with optimistic prospect of clinical application. Key words: Early colorectal carcinomas; Precancerous lesions; Endoscopic submucosal dissection