Endoscopic submucosal dissection or transanal endoscopic microsurgery for nonpolypoid rectal high grade dysplasia and submucosa-invading rectal cancer

Abstract

Both ESD and TEM are effective and oncologically safe for treating nonpolypoid rectal high grade dysplasia and submucosa-invading cancers. ESD has the additional advantages of minimal invasiveness and avoidance of anesthesia. Therefore, ESD could be recommended as a treatment option for superficial early rectal cancers.

Early rectal cancer: the European Association for Endoscopic Surgery (EAES) clinical consensus conference

“…To date, only a few studies and a systematic review and meta-analysis of the literature have compared these two approaches to early rectal neoplasms. In 2012, Park et al [132] retrospectively analyzed patients with non-polypoid rectal high grade dysplasia or submucosainvading cancer who were treated with ESD (30 patients) or TEM (33 patients). No significant differences were observed in en-bloc resection rates ( 96.7% vs. 100%; P = 0.476) and R0 resection rates (96.7 % vs. 97.0 %; P = 1.000) between ESD and TEM groups.…”

Efficacy and Safety of Endoscopic Submucosal Dissection for Colorectal Carcinoids

“…8,13,15,16 This may be due to burn or coagulation of the normal tissue outside the tumor during incising mucosal layer and dissecting submucosal layer. In some cases, the capture of the tumor could be found to M A N U S C R I P T 63% (176/190).…”

Current practices in endoscopic submucosal dissection for colorectal neoplasms: a survey of indications among Korean endoscopists

“…In Korea and Japan, ESD is routinely performed in the endoscopic treatment of superficial gastric neoplasias,456 and is becoming the standard treatment for colorectal neoplasias such as early colorectal cancer or benign colorectal tumors ≥2 cm for which en bloc resection with conventional endoscopic mucosal resection (EMR) is difficult. In a comparative study of ESD versus EMR for colorectal tumors ≥2 cm,789 there was a 2% recurrence rate in the ESD group versus 14% in the EMR group, which also required additional EMR.…”