2019 Volume 61 Issue 11 Pages 2498-2509
Although it has become possible to carry out colorectal endoscopic submucosal dissection (ESD) for large lesions and its safety and efficacy have been clarified, its technical difficulty is still high. This is because in addition to the technical elements required for normal colorectal ESD, it is necessary to devise a strategy unique to large lesions. During ESD for large lesions, the treatment must be assembled while constantly looking at the whole picture. In addition, in order to make effective use of gravity, the endoscopist should not hesitate to change the orientation of the patientʼs body and change the treatment tool to another tool as needed. It is most important to not be overconfident of oneʼs own ability so that the decision to discontinue the endoscopic procedure or shift to surgery is not delayed. We recommend that the endoscopist perform safe colonic ESD for large colorectal lesions after acquiring sufficient technical skill.
