Korean J Gastrointest Endosc.  2006 Jul;33(1):12-19.

Combined Endoscopic Submucosal Dissection and Snaring for the Resection of Colorectal Lesions

• Park HW
• Byeon JS
• Myung SJ
• Yang SK
• Jo JY
• Choi KD
• Lee GH
• Jung HY
• Hong WS
• Kim JH

Abstract

BACKGROUND/AIMS: Endoscopic en-bloc resection of the large colorectal lesions is technically difficult. The aim of this study is to evaluate the usefulness of combined endoscopic submucosal dissection (ESD) and snare resection for treating colorectal lesions.
METHODS
We enrolled 23 patients (M:F=14:9, age range: 46~76 years) with 25 colo rectal tumors that were around or above 20 mm in diameter. A combined treatment of ESD and snare resection was performed.
RESULTS
The mean size of the 25 lesions was 22.6+/-8.2 mm (range: 15.0~44.0 mm). Ten lesions were laterally spreading tumors and 15 lesions were found in the rectum. On the histopathologic examination, 16 lesions were adenocarcinoma, 2 lesions were villous adenoma, 1 lesion was a villotubular adenoma, 5 lesions were tubular adenoma and 1 lesion was a hyperplastic polyp. The mean resection time was 27+/-22 min (range: 10~91 min). En bloc resection was possible for 19 lesions (76%). Of these, 18 specimens showed clear resection margins and 1 showed a positive deep resection margin. Of the 6 piecemeal resection cases, 2 showed positive lateral resection margins. Therefore, an 88% tumor free resection rate was obtained.
CONCLUSIONS
Combined ESD and snare resection may be an effective and safe modality for the resection of large colorectal lesions.

Keyword

Endoscopic submucosal dissection; Snare resection; En-bloc resection; Colorectal neoplasm

MeSH Terms

Adenocarcinoma
Adenoma
Adenoma, Villous
Colorectal Neoplasms
Humans
Polyps
Rectal Neoplasms
Rectum
SNARE Proteins*
SNARE Proteins