Therapeutic value of endoscopic submucosal dissection for early stage colorectal cancer and precancerous lesions / 中华消化内镜杂志

ABSTRACT

Objective To investigate the safety and efficacy of endoscopic submucosal dissection ( ESD) for early stage colorectal cancer and precancerous lesions. Methods Clinical data of 108 patients who received ESD for early stage colorectal cancer and precancerous lesions from December 2016 to June 2017 in Renmin Hospital of Wuhan University were analyzed. The lesion characteristics, postoperative pathological features, intraoperative and postoperative complications and postoperative follow-up outcomes were analyzed. Results The 108 patients all underwent ESD successfully with median operation time of 45 min. The rate of intraoperative perforation and postoperative delayed bleeding was 2. 8％ ( 3/108) and 2. 8％ (3/108), respectively. No postoperative delayed perforation occurred. Postoperative pathology showed that there were 41 cases ( 38. 0％) of tubular adenoma, 4 ( 3. 7％) villous adenoma, 39 ( 36. 1％) villous tubular adenoma [ including 41 ( 38. 0％) low-grade intraepithelial neoplasia and 16 ( 14. 8％) high-grade intraepithelial neoplasia] , 19 ( 17. 6％) adenocarcinoma, and 5 ( 4. 6％) other types. Among the 19 cases of adenocarcinoma, there were 11 cases of well-differentiated, 5 median-differentiated and 3 low-differentiated. The complete resection rate was 100. 0％ and the en bloc resection rate was 92. 3％ ( 100/108) . The mean follow-up time was 8. 1 months, and no recurrence was found during this period. Conclusion ESD is safe and effective in the treatment of early stage colorectal lesions. It is important to improve preoperative assessment, strengthen surgical skills, analyze postoperative pathological features and regularly follow up to guarantee the treatment quality of ESD.