Comparison of endoscopic submucosal dissection and endoscopic mucosal resection for large colorectal tumors

Abstract

Despite its longer procedure time and higher perforation rate, ESD resulted in a higher en bloc resection rate and lower recurrence rate for larger colorectal tumors compared with EMR.

KRAS Mutant Status, p16 and β-catenin Expression May Predict Local Recurrence in Patients Who Underwent Transanal Endoscopic Microsurgery (TEMS) for Stage I Rectal Cancer

“…TEMS generally offers advantages in operative access and oncological clearance over transanal resection (TAR), but recently a number of similar logic techniques with various rectal ports for endoscopic excision of rectal tumours has been invented. Those methods are collectively named transanal minimal-invasive surgery (TAMIS) and for oncological purposes they share the same features of local excision as TEMS (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14).…”

Therapeutic and Diagnostic Approaches in Colonoscopy

“…The saline injection-assisted method was first described by Rosenberg, who identified it as a safe method for the removal of rectal and sigmoid polyps, and was reintroduced by Tada et al in 1984 [58-59]. Most adenomas and intramucosal cancers can be resected by EMR, however, tumors greater than 20 mm in diameter are considered difficult candidates for en bloc resection [60][61][62][63][64][65], and the rate of en bloc resection by EMR of tumors >20 mm in diameter is especially low (Table 5) [60][61][62][63][64][65]. While the technical feasibility of EMR for en-bloc and extended resections must still be improved, most colorectal polyps removed by EMR are <20 mm in size.…”

“…When en bloc resection of the tumor by EMR fails, piecemeal EMR is generally performed instead. Although piecemeal EMR enables the removal of large colorectal tumors, it has a high rate of local recurrence (7.9-21.4%) [60][61][62][63][64][65] (Table 5). Most recurrent adenomas, including partial intramucosal adenocarcinomas, can be cured by additional endoscopic therapy [74].…”

Meta-analysis comparing differing methods of endoscopic therapy for colorectal lesions

“…Specimens with clear lateral and basal margins of tumour were defined as an R0 resection, incomplete (R1) resection was defined as a positive lateral or basal margin for tumour and Rx resection where the margins of the specimen could not be evaluated due to piecemeal resection or as a result of thermal injury during resection. Tajika et al [22] 2011 Japan Full paper 189 104 61 59.9 ± 10.6 85 58 64.3 ± 9.2 Lee et al [23] 2012 [24] 2012 Japan Full paper 84 56 68 65.9 ± 9.9 28 68 65.1 ± 9.7 Saito et al [25] 2010 Japan Full paper 373 228 -64 ± 4 145 -64 ± 11 Kim et al [26] 2009 South Korea Abstract 121 76 --45 --Tamegai et al [19] Patel N et al . Meta-analysis comparing colorectal EMR and ESD…”

“…Eligible articles were reviewed independently by two investigators (NP and JA); data was extracted into a standardized data extraction form [19,[22][23][24][25][26] . Discrepancies were resolved by a third investigator (JT) who made the final decision for eligibility and data extraction.…”