Qi ZP, et al. - This study was designed to assess the efficacy, safety, and long-term outcomes of endoscopic submucosal dissection (ESD) for colorectal submucosal tumors (SMTs). Researchers identified ESD as effective for resection of colorectal SMTs and rarely causes serious adverse events. The complete resection rate and the development of serious adverse events seemed affected by tumor location and the experience of endoscopists. For large tumors and tumors in the muscularis propria, ESD was feasible but was associated with relatively high risks of adverse events.

Methods

• 412 consecutive patients with colorectal SMTs who underwent ESD at the Zhongshan Hospital of Fudan University from January 2008 to July 2014 were included retrospectively.
• Researchers analyzed tumor histopathology, completeness of resection, adverse events, tumor recurrence, and distant metastasis .

Results

• For 358 (86.9%) lesions, complete resection was achieved.
• Serious adverse events were encountered in thirteen patients(3.2%), these included bleeding and perforation. Post-ESD electrocoagulation syndrome (PEECS) was identified in 28 patients (6.8%).
• As a result of endoscopists performing more ESDs for colorectal SMTs, the rate of complete resection increased (78.5% vs 88.5%) and the rate of serious adverse events decreased (9.2% vs 2.0%).
• The SMTs in the colon had increased risk of incomplete resection (19.6% vs 11.3%), serious adverse events (8.7% vs. 1.6%), and PEECS (16.3% vs 4.1%).
• Increase in the rate of PEECS was observed with SMTs originating from the muscularis propria and size ≥20 mm (22.7% vs 5.9% and 31.3% vs 5.8%, respectively).