Original articleOutcomes of Endoscopic Submucosal Dissection for Colorectal Epithelial Neoplasms in 200 Consecutive Cases
Section snippets
Patients and Methods
Between July 2000–March 2006, 186 consecutive patients, who had a total of 200 colorectal epithelial neoplasms, gave written informed consent to be treated with ESD at our hospital. Surgery was performed by 2 ESD specialists who were highly experienced in performing ESD in the stomach. Lesions with an indication for ESD were determined by endoscopic features by using chromoendoscopy with or without magnifying endoscopy. In addition, endoscopic ultrasonography was performed for lesions with a
Results
Table 1 summarizes the clinicopathologic features of colorectal epithelial neoplasms treated by ESD. Even small tumors 6 mm in size were resected by ESD because of the existence of scarring that rendered them non-lifting and difficult to resect with conventional EMR. Twenty-six tumors (13%) were histologically revealed to be invasive carcinoma. Seven tumors (3.5%), 6 with SM2 or deeper invasion including 2 tumors with vessel infiltration and 1 tumor with SM1 invasion plus vessel infiltration,
Discussion
Several clinical studies regarding the efficacy and safety of ESD in the stomach have been reported. The technique shows high tumor eradication rates but substantial risks during the procedure.6 We previously reported the possibility of using ESD in the esophagus21 and the rectum,7 which showed results similar to those of the stomach case series.6 These findings suggest a high likelihood of successful application in the whole colorectum, but the key issue might be how to innovate in the
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