Abstract
Comparison of Endoscopic Submucosal Dissection Versus Endoscopic Mucosal Resection for Large Superficial Colorectal Tumor Naoto Sakamoto, Hideaki Ritsuno, Taro Osada, Kosaburo Nakae, Hiroki Mori, Kenshi Matsumoto, Kazuko Beppu, Tomoyoshi Shibuya, Takashi Yoshizawa, Akihito Nagahara, Michiro Otaka, Tatsuo Ogihara, Sumio Watanabe Department of Gastroenterology, Juntendo University, Tokyo, Japan Background and Aims: Endoscopic submucosal dissection (ESD) allows en bloc resection of large gastrointestinal neoplasms, regardless of their size. Recently, this method was applied for superficial colorectal tumor known as laterally spreading tumors (LSTs). However, technical difficulties associated with ESD in the colorectum make it less widely applied in the treatment of tumors in this region. The aim of this study was to evaluate the effectiveness of ESD and EMR for large colorectal LSTs 20 mm in diameter. Methods: Three hundred thirty one patients with 341 LSTs 20 mm were treated by ESD or EMR between Jan 1995 and Nov 2010. The size of the resected tumor, en-bloc resection rate, histopathological findings, complications, and recurrence rate were analyzed and compared between the ESD group and EMR group. Results: Results were shown in Table 1. ESD group showed significantly higher en-bloc resection rate and lower recurrence rate than those of EMR group (p 0.01).Major complication rate was not significantly different between ESD group and EMR group. Conclusions: Our results indicate that ESD is appropriate for colorectal LSTs 20 mm without any greater risk than EMR. We conclude that ESD will become a standard technique for large superficial colorectal tumors.
Published Version
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