Endoscopic submucosal dissection for rectal-sigmoid laterally spreading tumors ≥10 cm: an analysis of 10 cases

Endoscopic submucosal dissection (ESD) is a standard method for treating selected colorectal laterally spreading tumors (LSTs). However, technical difficulty occurs with the increase in tumor size, and little is known about the efficacy of ESD treatment in colorectal LSTs ≥10 cm. The present study aimed to report the feasibility, safety, and efficacy of ESD for rectal-sigmoid LSTs ≥10 cm. From May 2012 to December 2019, patients with rectal-sigmoid LSTs ≥10 cm and underwent colorectal ESD were enrolled retrospectively. Demographic features, procedure-related parameters (procedure time, adverse events, rate of en bloc resection and complete resection), and follow-up results were recorded and analyzed. A total of 10 patients successfully underwent ESD: nine patients received conventional ESD, while the other one underwent tunneling ESD. The median diameter of the LSTs was 11.5 cm, and the median procedure time was 210 minutes. The rates of en bloc and curative resection rates were 100% and 90%, respectively. Of the ten patients, four had developed adverse events, one had intraoperative bleeding, two patients had delayed bleeding, and the other one had postoperative fever and rectum stricture postoperatively. None of the patients experienced recurrence during a median follow-up of 62 months. ESD can be used as a feasible, safe and effective treatment modality for the management of rectal-sigmoid LSTs ≥10 cm.