Endoscopic treatment of large colorectal tumors: comparison of endoscopic mucosal resection, endoscopic mucosal resection–precutting, and endoscopic submucosal dissection

Abstract

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.

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

“…Tajika et al [22] 53.8 ± 44.6 (3 Lee et al [23] 26 ( Kobayashi et al [24] 38 ( Saito et al [25] 26 ± 17 (6-68) 20 ± 13 (6-61) 14 2 94 100 -:3/3 --2/33:0 0:0 30/33: 3/33:0 3/33 Kim et al [26] 12 (6-12)…”

“…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.…”

“…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…”

Predictive factors for technically difficult endoscopic submucosal dissection in large colorectal tumors

“…This was a retrospective study using a database of 36 patients with large tumor sizes (>10 cm 2 ) from October 2012 to January 2015 and who had been referred to PLA Army General Hospital for ESD. This study was approved by the Institutional Review Board of PLA Army General Hospital.…”

“…Early-stage tumors in the gastrointestinal tract can be resected en bloc using endoscopic submucosal dissection (ESD), despite their large size (1,2). This enables a detailed histological evaluation, the accurate judgment of resected margins, and a high rate of curative resection even with the presence of scarring or difficult location (3,4).…”