Endoscopic Submucosal Dissection for Colorectal Tumors

Endoscopic submucosal dissection (ESD) is a resection technique for superficial neoplastic lesions of the gastrointestinal tract without the use of snaring. It was developed for en bloc resection of large superficial mucosal tumors and initially used in the stomach, then later in the esophagus and colon and rectum as well. ESD provides a reliable en bloc resection of the lesions with a high complete resection rate and a low recurrence rate. However, it can be curative only when the tumors are localized without metastases. Staging of the tumor with precise endoscopic examination is important to select tumors appropriate for ESD. Moreover, a complete curative resection should be confirmed by detailed pathological examination of the resected tissue. The techniques of ESD for colorectal tumors are described in detail here.