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Hybrid-ESD has a high therapeutic resection rate of colorectal polyps

The latest European Journal of Gastroenterology evaluates the treatment of large colorectal neoplasms by endoscopic submucosal dissection.

News image

Endoscopic submucosal dissection (ESD) has a high curative resection rate for gastrointestinal mucosal lesions, but is not used widely in Europe because of a high complication rate and a long learning curve.

Dr Andrzej Białek and colleagues analyzed the ESD learning curve at a single European treatment center.

ESD and hybrid-ESD (hESD) procedures were used to treat large colonic lesions that could not be resected in one piece by other endoscopic methods.

Procedure duration and speed, and en-bloc, complete (R0) resection, and complication rates were analyzed.

The team reported that 53 patients underwent ESD, most with rectal lesions.

The mean lesion diameter was 4 cm, the median procedure duration was 70 min, and the median treatment speed was 0.086 cm2/min.
En-bloc resection rates were 87%
European Journal of Gastroenterology & Hepatology

En-bloc and R0 resection rates were 87%, and 81%, respectively.

Procedure speed increased significantly after about 25 cases.

The research team found that the median hESD procedure treatment speed was 0.159 cm2/min, which was better than with classical ESD.

The team noted that the hESD en-bloc and R0 resection rates were comparable to those of classical ESD.

The researchers observed that the only complication was bleeding, and no perforation occurred.

Recurrence was detected during follow-up in 1 patient.

Dr Białek and colleagues conclude, "ESD is useful and safe for resection of large colorectal polyps, and procedure speed increased considerably after 25 procedures."

"hESD was faster than ESD, with a high therapeutic resection rate."

Eur J Gastroenterol Hepatol 2014: 26(6): 607-615
13 May 2014

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