Korean J Gastrointest Endosc > Volume 39(3); 2009 > Article
Korean Journal of Gastrointestinal Endoscopy 2009;39(3): 136-142.
단일 기관에서 대장종양 치료로 시행한 내시경 점막하 박리술의 유용성과 안전성
계명대학교 의과대학 내과학교실
The Efficacy and Safety of Endoscopic Submucosal Dissection in Colorectal Neoplasms: Single Center Study
Hye Jin Seo, M.D., Kwang Bum Cho, M.D., Seok Guen Lee, M.D., Hong Seok Lee, M.D., Eun Soo Kim, M.D., Byoung Kuk Jang, M.D., Kyung Sik Park, M.D., Woo Jin Chung, M.D. and Jae Seok Hwang, M.D.
Department of Internal Medicine, Keimyung University College of Medicine, Daegu, Korea

Endoscopic submucosal dissection (ESD) is not commonly used in the colorectal area because of technical difficulty and due to the characteristics of the organ. We therefore wanted to determine the efficacy and safety of endoscopic submucosal dissection in colorectal neoplasms.
Colorectal tumor lesions resected by ESD in a single medical center were analyzed retrospectively.
A total of 47 patients were treated for 50 lesions. Mean age was 64.3±9.8 (43∼85) years. Laterally spreading tumors were the most common type (44, 88%) followed by Is+IIa type tumors (6, 12%). The en bloc resection rate was 76% and the complete resection rate was 74%. The mean procedure time was 81.1±44.7 (20∼180) minutes. The mean size of resected specimen was 26.9±10.4 (10∼50) mm. The histological diagnosis determined that 24 lesions (48%) were tubular adenoma, 18 lesions (36%) were intramucosal cancer, 7 lesions (14%) were sm1 cancer and 1 lesion (2%) was over sm2 cancer. Bleeding occurred in 6 (12%) and perforations in 13 (26%) of the patients and all were treated successfully by endoscopic or conservative treatment. The concordance rate of pre and post ESD pathological diagnosis was only 47%.
ESD is a feasible technique for treating superficial colorectal tumors with a high complete resection rate, minor invasiveness, and a high safety rate. In addition, ESD might be useful in establishing the complete pathological evaluation of colorectal epithelial neoplasm. (Korean J Gastrointest Endosc 2009;39:136-142)
Key Words: Endoscopic submucosal dissection, Colorectal neoplasm, En bloc resection
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