Comparison of Endoscopic Submucosal Dissection (ESD) Using Sodium Hyaluronate and Needle-Knife Versus Endoscopic Mucosal Resection (EMR) for Laterally Spreading Tumor (LST) of the Colon

Colon tumors and colonoscopy

“…Since en bloc resection by ESD facilitates accurate histological evaluation, this technique has been developed to treat gastrointestinal tract lesions. Outcomes of the ESD method using sodium hyaluronate and a needle knife for colorectal LSTs were compared with those of EMR, in 106 patients (66 men, 40 women; mean age 67.3 years, range 40 -84), with 60 undergoing ESD and 46 EMR [18]. The mean resected specimen size was 29.1 mm diameter (range 10 -65 mm) in the ESD group and 18.2 mm (range10 -55 mm) for EMR (P < 0.01).…”

“…A noteworthy amount of active bleeding occurred during three ESD and two EMR procedures, but endoscopic hemostasis was successful in all cases. The results indicated that ESD using sodium hyaluronate and a needle knife is feasible for treatment of colorectal LSTs, without any greater risk than the EMR technique, and that ESD might be a more reliable treatment for colorectal LST than EMR [18]. The use of the hook knife for endoscopic submucosal resection (ESD) of 22 large colorectal tumors was evaluated with regard to feasibility, safety, and complications [19], in patients with laterally spreading tumors (LSTs).…”