For the treatment of large, nonpedunculated colorectal tumors, ESD is more effective than either EMR or EMR-P. Although ESD is technically demanding, it has clinical significance by overcoming the limitations of both EMR and EMR-P.

ESD is technically difficult, with a substantial risk of perforation. However, ESD enabled en bloc resection and pathologically complete resection of large colorectal epithelial tumors and submucosal tumors. As experience with the technique increases, ESD may gradually replace piecemeal endoscopic mucosal resection and radical colon resection in the treatment of colorectal tumors.

Perforation rate was 7.4%, and most cases could be successfully managed nonsurgically. In case of laterally spreading type of tumor, more caution is needed during submucosal dissection and long-lasting submucosal cushion is important for preventing perforation.

This research examines the impact of internationalization on small and medium enterprise (SME) survival, and the direct and moderating effects of technology resources and research and development (R&D) alliances. Our survey examination of 1,612 Korean SMEs reveals that sales internationalization is associated with better survival prospects, suggesting that failure risk does not increase with cross-border sales. In addition, though technology resources provide no direct survival benefits, R&D intensity acts as a moderator in the internationalization-to-survival relationship. R&D alliances, on the other hand, are directly linked with survival but do not show a moderating effect. This supports the liabilities of newness and smallness view that external relationships can help counter survival threats but suggests that the accumulation of technology resources may be more important when firms seek international expansion.