Long-term outcomes after endoscopic submucosal dissection for superficial colorectal tumors

Endoscopic submucosal dissection in the West: Current status and future directions

“…A recent Japanese study of 257 colonic LST with suspected superficial invasive disease assessed outcomes following ESD with follow up to 5 years . In this study, only 7.1% of the lesions resected by ESD actually had superficial SMI, 79.1% would have been suitably treated by EMR and 13.8% had deep invasion and therefore required surgery . Although HGD is associated with increased adenomatous recurrence, its incidence after EMR can be significantly reduced by close endoscopic follow up and use of adjunctive techniques such as snare tip soft coagulation (STSC) to the resection margin .…”

“…In addition, the benefit of colonic ESD may be overemphasized. A recent Japanese study of 257 colonic LST with suspected superficial invasive disease assessed outcomes following ESD with follow up to 5 years . In this study, only 7.1% of the lesions resected by ESD actually had superficial SMI, 79.1% would have been suitably treated by EMR and 13.8% had deep invasion and therefore required surgery .…”

Efficacy of traction‐assisted colorectal endoscopic submucosal dissection using a clip‐and‐thread technique: A prospective randomized study

“…Endoscopic submucosal dissection (ESD) for large SCN—which achieves high complete resection and low recurrence rate (0.4–1.0%)—was developed and recognized as a standard treatment in Japan. In Western countries, however, ESD is not popular because of technical difficulty, longer procedure time, and higher risk of adverse events than with EMR . Even in Japan, it would be challenging for less‐experienced operators because visualization of appropriate operating site and maintaining good maneuverability are difficult .…”

Line‐assisted complete closure for a large mucosal defect after colorectal endoscopic submucosal dissection decreased post‐electrocoagulation syndrome

“…Endoscopic submucosal dissection (ESD) is a promising procedure for removal of large colorectal neoplasms because it achieves a high en bloc resection rate and low recurrence rate . However, colorectal ESD is still technically difficult, and adverse events are thus encountered at a certain frequency .…”