A Relatively New Colonoscopic Approach to Large Dysplastic Lesions

Clinical Takeaway

: In expert hands, endoscopic submucosal dissection achieved complete resection in most cases.

Context

Sometimes a high-risk neoplastic colorectal lesion is not removed completely with standard colonoscopic techniques. A specialized procedure called endoscopic submucosal dissection (ESD) is being used increasingly to resect residual neoplastic tissue during subsequent colonoscopy. In this retrospective study, physicians with expertise in ESD describe their experience in 415 cases drawn from a large group of referral centers.

Key Results

The median size of the colorectal lesion that had been resected incompletely during previous colonoscopy was 3.5 cm; most lesions were adenomas with dysplasia. Outcomes of subsequent ESD were as follows:

Complete endoscopic resection was achieved in 98% of cases.
Almost three quarters of resections were co…

Reviewing Author

Allan S. Brett, MD

Disclosures

Nothing to disclose