Colorectal Endoscopic Submucosal Dissection: An Update on Best Practice
Tara Keihanian,1 Mohamed O Othman2 1Division of Gastroenterology, University of Miami Miller School of Medicine, Miami, FL, USA; 2Gastroenterology and Hepatology Section, Baylor College of Medicine, Houston, TX, USACorrespondence: Mohamed O OthmanGastroenterology and Hepatology Section, Baylor Colle...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2021-08-01
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| Series: | Clinical and Experimental Gastroenterology |
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| Online Access: | https://www.dovepress.com/colorectal-endoscopic-submucosal-dissection-an-update-on-best-practice-peer-reviewed-fulltext-article-CEG |
| _version_ | 1818356564301447168 |
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| author | Keihanian T Othman MO |
| author_facet | Keihanian T Othman MO |
| author_sort | Keihanian T |
| collection | DOAJ |
| description | Tara Keihanian,1 Mohamed O Othman2 1Division of Gastroenterology, University of Miami Miller School of Medicine, Miami, FL, USA; 2Gastroenterology and Hepatology Section, Baylor College of Medicine, Houston, TX, USACorrespondence: Mohamed O OthmanGastroenterology and Hepatology Section, Baylor College of Medicine, 7200 Cambridge St., 8th Floor, Suite 8B, Houston, TX, 77030, USAEmail Mohamed.othman@bcm.eduAbstract: Endoscopic submucosal dissection (ESD) is a method of en-bloc resection of neoplastic colorectal lesions which is less invasive compared to surgical resection. Lesion stratification, architecture recognition and estimation of depth of invasion are crucial for patient selection. Expert endoscopists have integrated a variety of classification systems including Paris, lateral spreading tumor (LST), narrow band imaging (NBI), international colorectal endoscopic (NICE) and Japanese NBI expert team (JNET) in their day-to-day practice to enhance lesion detection accuracy. Major societies recommend ESD for LST-non granular (NG), Kudo-VI type, large depressed and protruded colonic lesions with shallow submucosal invasion. Chance of submucosal invasion enhances with increased depth as well as tumor location and size. In comparison to endoscopic mucosal resection (EMR), ESD has a lowerl recurrence rate and higher curative resection rate, making it superior for larger colonic lesions management. Major complications such as bleeding and perforation could be seen in up to 11% and 16% of patients, respectively. In major Western countries, performing ESD is challenging due to limited number of expert providers, lack of insurance coverage, and unique patient characteristics such as higher BMI and higher percentage of previously manipulated lesions.Keywords: endoscopic submucosal dissection, colonic neoplasm, endoscopic mucosal resection |
| first_indexed | 2024-12-13T19:59:13Z |
| format | Article |
| id | doaj.art-3715d6e14d4348c5a2cda3be5a851ea2 |
| institution | Directory Open Access Journal |
| issn | 1178-7023 |
| language | English |
| last_indexed | 2024-12-13T19:59:13Z |
| publishDate | 2021-08-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Clinical and Experimental Gastroenterology |
| spelling | doaj.art-3715d6e14d4348c5a2cda3be5a851ea22022-12-21T23:33:13ZengDove Medical PressClinical and Experimental Gastroenterology1178-70232021-08-01Volume 1431733067483Colorectal Endoscopic Submucosal Dissection: An Update on Best PracticeKeihanian TOthman MOTara Keihanian,1 Mohamed O Othman2 1Division of Gastroenterology, University of Miami Miller School of Medicine, Miami, FL, USA; 2Gastroenterology and Hepatology Section, Baylor College of Medicine, Houston, TX, USACorrespondence: Mohamed O OthmanGastroenterology and Hepatology Section, Baylor College of Medicine, 7200 Cambridge St., 8th Floor, Suite 8B, Houston, TX, 77030, USAEmail Mohamed.othman@bcm.eduAbstract: Endoscopic submucosal dissection (ESD) is a method of en-bloc resection of neoplastic colorectal lesions which is less invasive compared to surgical resection. Lesion stratification, architecture recognition and estimation of depth of invasion are crucial for patient selection. Expert endoscopists have integrated a variety of classification systems including Paris, lateral spreading tumor (LST), narrow band imaging (NBI), international colorectal endoscopic (NICE) and Japanese NBI expert team (JNET) in their day-to-day practice to enhance lesion detection accuracy. Major societies recommend ESD for LST-non granular (NG), Kudo-VI type, large depressed and protruded colonic lesions with shallow submucosal invasion. Chance of submucosal invasion enhances with increased depth as well as tumor location and size. In comparison to endoscopic mucosal resection (EMR), ESD has a lowerl recurrence rate and higher curative resection rate, making it superior for larger colonic lesions management. Major complications such as bleeding and perforation could be seen in up to 11% and 16% of patients, respectively. In major Western countries, performing ESD is challenging due to limited number of expert providers, lack of insurance coverage, and unique patient characteristics such as higher BMI and higher percentage of previously manipulated lesions.Keywords: endoscopic submucosal dissection, colonic neoplasm, endoscopic mucosal resectionhttps://www.dovepress.com/colorectal-endoscopic-submucosal-dissection-an-update-on-best-practice-peer-reviewed-fulltext-article-CEGendoscopic submucosal dissectioncolonic neoplasmendoscopic mucosal resection |
| spellingShingle | Keihanian T Othman MO Colorectal Endoscopic Submucosal Dissection: An Update on Best Practice Clinical and Experimental Gastroenterology endoscopic submucosal dissection colonic neoplasm endoscopic mucosal resection |
| title | Colorectal Endoscopic Submucosal Dissection: An Update on Best Practice |
| title_full | Colorectal Endoscopic Submucosal Dissection: An Update on Best Practice |
| title_fullStr | Colorectal Endoscopic Submucosal Dissection: An Update on Best Practice |
| title_full_unstemmed | Colorectal Endoscopic Submucosal Dissection: An Update on Best Practice |
| title_short | Colorectal Endoscopic Submucosal Dissection: An Update on Best Practice |
| title_sort | colorectal endoscopic submucosal dissection an update on best practice |
| topic | endoscopic submucosal dissection colonic neoplasm endoscopic mucosal resection |
| url | https://www.dovepress.com/colorectal-endoscopic-submucosal-dissection-an-update-on-best-practice-peer-reviewed-fulltext-article-CEG |
| work_keys_str_mv | AT keihaniant colorectalendoscopicsubmucosaldissectionanupdateonbestpractice AT othmanmo colorectalendoscopicsubmucosaldissectionanupdateonbestpractice |