Evaluation of endoscopic mucosal resection and endoscopic submucosal dissection in submucosal lesions of the colon and rectum

Abstract

Introduction: Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are commonly used for the minimally invasive treatment of submucosal lesions of the gastrointestinal tract. Aim: To evaluate the safety, efficacy, outcome and recurrence rate of EMR and ESD for mucosal and submucosal lesions in the colon and rectum. Material and methods: Records of 26 patients who underwent ESD and EMR for mucosal and submucosal lesions in the colon and rectum between January 2013 and March 2018 in our endoscopy unit were retrospectively reviewed. Results: A total of 26 patients (6 female and 20 male) were evaluated. The mean age of the patients was 58.03 ±15.19 (21–80). Fifteen patients underwent ESD and EMR for rectal lesions. Tubular adenomas were found in 3 of these patients, tubulo-villous adenomas in 2, inflammatory polyps in 1, neuroendocrine tumors in 2 and carcinomas in 7 (intramucosal, in-situ and invasive). Eleven patients underwent ESD and EMR for colonic lesions. Villous adenomas were found in 2 of these patients, tubular adenoma showing dysplasia in 2, tubulo-villous adenomas showing dysplasia in 1 and carcinoma (in-situ, invasive and intramucosal) in 6. Two lesions were resected with secondary transanal local excision to obtain free margins. The follow-up period was 3 to 48 months and no recurrence was observed. Conclusions: The EMR and ESD are reliable minimally invasive techniques with a low rate of complications and short hospital stay in the treatment of colon and rectal lesions, including early stage carcinomas of different size and morphology.