Therapeutic efficacy and safety of endoscopic submucosal dissection for early colorectal carcinoma and precancerous lesions / 中华消化内镜杂志

ABSTRACT

Objective To evaluate the therapeutic effectiveness and safety of endoscopic submucosal dissection(ESD)for early colorectal carcinoma and its precancerous lesions. Methods The clinical pathologi-cal characteristics,en bloc resection rate,curative resection rate,complications and follow-up results of 21 pa-tients with early colorectal carcinoma or precancerous lesions,who were treated by ESD,were retrospectively analyzed. Results Most lesions were located in left colon,which accounted for 80. 9%(17/ 21).The most com-mon macroscopic morphology(TypeⅠ)was protrusion type(61. 9%,13/ 21),while flat type was the least (14. 3%,3/ 21). The mean procedure time was 79(35-120)min. The en blot resection rate was 100. 0%(21/ 21),and curative resection rate was 85. 7%(18/ 21). Postoperative hemorrhage occurred in 1 patient (4. 7%,1/ 21)and postoperative infection occurred in 1(4. 7%,1/ 21)and no perforation was recorded. Tubu-lar adenoma with high-grade intraepithelial neoplasia(LGIEN)was the most occurence(33. 3%,7/ 21),villous adenoma with LGIEN was the least(4. 7%,1/ 21). No local recurrence or metastasis was observed during follow-up of 3-20 months. Conclusion ESD is safe,effective,minimal invasive for early colorectal carcinoma and its precancerous lesions,with optimistic prospect of clinical application.