Is Colorectal Endoscopic Submucosal Dissection Safe and Effective For 15–19 mm Tumors?

Abstract

Abstract Purpose The outcomes of colorectal endoscopic submucosal dissection (ESD) in 15–19 mm tumors are unclear. This study compared the effectiveness and safety of colorectal ESD for 15–19 mm tumors and tumors exceeding that size. Methods From August 2018 to December 2020, 213 cases of colorectal tumors removed by colorectal ESD at a tertiary hospital were enrolled in this study. The cases were divided into two groups according to the pathologically measured size of the resected lesion: an intermediate group (15–19 mm, n = 62) and a large group (≥ 20 mm, n = 151). The en bloc resection rate, complete resection rate, and complications were investigated retrospectively. Results The en bloc resection rate was significantly higher in the intermediate than large group (100% vs. 94%, p = 0.049), and the mean total procedure time was shorter in the intermediate than large group (29.2 ± 12.6 vs. 48.4 ±28.8 min, p < 0.001). However, the mean procedure speed was significantly lower in the intermediate than large group (0.25 ± 0.10 vs. 0.28 ± 0.11 cm2/min; p = 0.031). The complete resection rate, post-procedural bleeding, and perforation rate were not significantly different between the two groups. In multivariate analyses, the total procedure time and mean procedure speed were significantly associated with lesion size. Conclusion Colorectal ESD of 15–19 mm lesions is effective, and has a shorter procedure time and higher en bloc resection rate than the same procedure for larger lesions.