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Chinese Journal of Gastrointestinal Endoscopy(Electronic Edition) ›› 2020, Vol. 07 ›› Issue (04): 186-189. doi: 10.3877/cma.j.issn.2095-7157.2020.04.003

Special Issue:

• Original Article • Previous Articles     Next Articles

Clinical Study of endoscopic submucosal dissection in the treatment with lateral colorectal polyps

Mizhu Wang1, Xianmei Meng1, Tong Dang1,()   

  1. 1. The Second Affiliated Hospital of Baotou Medical College of Inner Mongolia University of Science and Technology, Baotou 014030, China
  • Received:2020-03-20 Online:2020-11-15 Published:2021-03-19
  • Contact: Tong Dang

Abstract:

Objective

To evalute the practical value of endoscopic submucosal dissection (ESD) for treatment of lateral colorectal polyps.

Methods

Retrospective analysis was performed on 45 cases of lateral colorectal polyps found by colonoscopy in endoscopy center of Inner Mongolia institute of digestive diseases from January 2018 to December 2019. IT knife and HOOK knife were applied in the ESD treatment. ESD success rate, lesion size, operation time, complications and recurrence rate were evaluated.

Results

45 cases with colorectal lesions were enrolled in this study. ESD was given up in 2 cases of lateral colorectal polyps with non-lifting sign.3 cases had tumor residue in the wound after ESD and one receieved an additional operation after failed conservative therapy.The success rate of ESD was 88.9% (40/45). The diameters of the lesions ranged from 1.5 to 6.3 cm with mean size of 3.6 cm.The mean ESD procedure time was 67 minutes (ranged from 31 to 125 minutes).3 cases had hematochezia after ESD and one of whom failed after conservative treatment and bleeding was controlled by electrocoagulation under endoscope. The bleeding rate was 7.0%(3/43). Perforation occurred in 4 cases during the dissection of the lesions, which was typically closed with metallic endoclips without surgical treatment. The perforation rate of ESD was 9.3%(4/43). All the 40 patients were followed up after ESD, with confirmed healing of the artificial ulcer with no residue or recurrence.

Conclusions

ESD for lateral colorectal polyps is of reliable curative effect as it can not only wholly remove the lesions but also provide pathological proof for reference with low recurrence rate. Bleeding and perforation are the main short-term complications.

Key words: Endoscopic submucosal dissection, Colorectal adenoma, The laterally spreading tumors

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