Clinical outcomes of ESD for superficial rectal tumors >50 mm in diameter

Abstract

Endoscopic submucosal dissection (ESD) can be performed en bloc for large superficial colorectal tumors that are difficult to resect, but requires considerable technical skill. Is safe, reliable treatment possible for large superficial rectal tumors ＞50 mm？ We retrospectively analyzed 160 patients with superficial rectal tumors, divided into 2 groups by tumor diameter : ＞50 mm (L group : 44 lesions) and＜50 mm (S group : 116 lesions) . The groups did not significantly differ by clinical background, en bloc resection rate and curative resection rate. Procedure duration was prolonged in the L group (146.4 : 52.3 min) , but performance speed was lower despite the large tumor size (38.7 ; 23.8 mm²/min) . Perforation occurred in 2 L group patients but was endoscopically managed. Postoperative hospitalization was longer in the L group (12.95 : 9.00 days) . Difficulty performing the procedure was greater for large tumors than small tumors. But ESD is safe, reliable, and possibly beneficial despite the large tumor size.