Colon Endoscopic Submucosal Dissection

Colon Endoscopic Submucosal Dissection

Sergey V. Kantsevoy, MD, PhD

Endoscopic submucosal dissection (ESD) was developed in Japan for en bloc removal of gastric cancer and precancerous lesions located in the upper gastrointestinal (GI) tract.1,2 ESD is now also used for removal of lesions located in esophagus, colon, and small bowel.3,4

In United States, a well-established screening for colorectal cancer has led to increased detection of precancerous colonic lesions (polyps) and early colon cancer.5 Traditionally these lesions were removed with endoscopic mucosal resection (EMR) utilizing various endoscopic snares. However, en bloc resection rate during EMR is relatively low and only possible for relatively small lesions fitting the size of endoscopic snare.6 Removal of large colonic lesions with EMR requires a piecemeal resection with a high rate (16%) of residual polyps on follow-up colonoscopy.7

Compared to EMR, ESD allows en bloc resection even for large and flat colonic lesions.6

May 29, 2020 | Posted by in GASTROENTEROLOGY | Comments Off on Colon Endoscopic Submucosal Dissection

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