Endoscopic Treatment Strategy for Large Laterally Spreading Tumor: Endoscopic Piecemeal Mucosal Resection or Endoscopic Submucosal Dissection

摘要

Background/Aims The therapeutic strategy between endoscopic piecemeal mucosal resection (EPMR) and endoscopic submucosal dissection (ESD) for large laterally spreading tumors (LSTs) has not been clearly defined. The aim of this study was to compare the clinical outcomes between EPMR and ESD in patients with large LST. Methods From July 2006 to September 2010, 106 patients who underwent endoscopic resection for large (>20 mm) LSTs were included in our retrospective analysis. Results Baseline characteristics of the patients and tumors were not different between two groups except for location (EPMR-right colon, ESD-rectum). The en bloc resection rate and complete resection rate were significantly higher in the ESD group than those in the EPMR group (EPMR vs. ESD, 53.5% vs. 88.6, P Conclusions The therapeutic strategy for choosing between EPMR and ESD for large LST lesions should be determined based on the macroscopic findings of their subtype. En bloc resection with ESD should be applied to LST-PDs due to their higher rate of submucosal invasion.