The Selection Of Endoscopic Treatment Method For Early Colorectal Tumors

Purpose Endoscopy technology continues to evolve, more and more early colorectal lesions be detectable in the early and receive timely minimally invasive treatment. This paper aims to evaluate the endoscopic mucosal resection and endoscopic submucosal dissection in the treatment of early colorectal lesions. Simultaneous analysis of endoscopic treatment of early colorectal cancer or precancerous lesions of the specimen after surgery, the application of Array-CGH technology to detect changes in gene copy number, explore the application of Array-CGH technology tendency to malignant transformation in colorectal cancer early diagnosis and assessment of adenoma feasibility and effectiveness.Objective To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) for rectal carcinoid tumors by comparing with endoscopic mucosal resection (EMR).Methods Data of patients with rectal carcinoid tumors between2010-5to2012-5, who received EMR (n=24) or ESD(n=19) were reviewed to compared the diameter measured by EUS,operation time,en bloc resection rate, complication,R0resection rate, and recurrence rate between2methods.Results Diameter measured by EUS of ESD group(7.4±5.3mm) were significantly higher than those of EMR group(5.6±2.1mm)(P<0.05). Mean operation time of ESD group (32.6±10.5min) was significantly longer than that of EMR group (8.9±6.3min)(P<0.05).En bloc resection and R0resection rates were not significantly different between EMR (100%,100%respectively) and ESD group (100%,95%respectively). Complications including perforation, delayed hemorrhage of EMR group(15.3%) was significantly higher than ESD groups(5%)(P<0.05). No local recurrence had been detected in either the EMR or ESD groups.Conclusion For diameter less than7mm lesions applications EMR method can effectively complete resection of the lesions and shorten the operation time. For diameter greater than7mm and after multiple biopsies or partial resection, endoscopic injection flattering intrinsic-negative lesions, take ESD in order to get satisfactory therapeutic effect.