Colorectal Endoscopic Submucosal Dissection can Reduce the Number of Operations for Adenomas and Mucosal Carcinomas

Abstract

[Objectives] From the viewpoint of the surgical department, we evaluated changes in the treatment of colorectal tumors after the introduction of colorectal endoscopic submucosal dissection (ESD). [Methods] The subjects consisted of patients with colorectal tumors (adenomas or early stage carcinomas) treated during an 8-year period before or after the introduction of ESD. Changes in the number of patients with an adenoma or M/SM carcinomas endoscopic resection and that of patients with an adenoma or M/SM carcinomas without risk factors for lymph node metastasis treated by surgical resection were evaluated. [Results] After the introduction of ESD, all colorectal adenomas were endoscopically resected. Both the number of M/SM carcinomas endoscopically resected and percentage of lesions treated by curative resection increased. The number of patients without risk factors for lymph node metastasis who underwent surgical resection was 27 (4.7％) before ESD introduction, but decreased to 9 (2.8％) during its introduction period, and 6 (1.2％) after its introduction (p<0.01) [Discussion] From the viewpoint of the surgical department, colorectal ESD can reduce the number of adenomas and mucosal carcinomas that cannot be resected by conventional EMR and are resected by surgical operation.