Endoscopic treatment of large colorectal lesions: A retrospective analysis of efficacy and safety
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND The incidence and mortality of colorectal cancer continue to rise. For early-stage colorectal cancer, endoscopic resection has become a preferred or important treatment option due to its significant advantages in operative time, extent of trauma, and medical costs. However, increasing lesion diameter significantly elevates the technical difficulty of endoscopic resection. Currently, robust evidence-based evidence regarding the upper size limit for safely and effectively resecting lesions endoscopically remains lacking. AIM To evaluate the efficacy and safety of endoscopic resection for colorectal lesions ≥ 30 mm in diameter. METHODS This retrospective study reviewed data from 102 patients who underwent endoscopic resection for colorectal lesions measuring ≥ 30 mm in diameter at General Hospital of Northern Theater Command between January 2023 and July 2024. RESULTS Among 102 patients who underwent endoscopic resection, 99 received endoscopic submucosal dissection and 3 underwent endoscopic full-thickness resection. Four patients (3.9%) required conversion to surgical radical resection postoperatively. All patients exhibited favorable wound healing at the resection sites, and no long-term complications were observed during the 3-month postoperative colonoscopy follow-up. The primary perioperative complication was post-endoscopic submucosal dissection electrocoagulation syndrome (PEECS) (24/102, 23.5%). Multivariate analysis identified lesion location in the transverse colon as an independent risk factor for PEECS occurrence (odds ratio = 6.734, 95% confidence interval: 1.623-27.945, P = 0.009). CONCLUSION Large colorectal lesion diameter does not constitute an absolute contraindication to endoscopic resection. Experienced endoscopic centers can achieve complete resection with a favorable efficacy and safety profile. Notably, lesion location in the transverse colon is identified as an independent risk factor for PEECS.
Authors: Wen-Wen Zhu, Xin Yang, Zhuo Yang, Jiao Liu, Wen Jia, Xu-Lin Chen, Ye Tian, Teng-Jiao Gao, Guo-Yao Sun, Meng Zhang, Chuan-Hong Liu, Jing-Yi Yu, Jian-Feng Huo, Huan-Nan Zhao
Institution: General Hospital of Shenyang Military Region
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4415212773