Saline-immersion therapeutic endoscopy for endoscopic submucosal dissection of fibrosed lesion: results from a single centre retrospective study

Aims Fibrosis is a crucial factor to consider when performing endoscopic submucosal dissection (ESD) in the colorectum. The degree of fibrosis has been associated with longer procedure time, failed en-bloc resection, lower R0 (~ 80% for F1 fibrosis; ~ 30-50% for F2 fibrosis), lower curative rates and higher risk of adverse events [1] [2] [3] [4] [5] [6]. Fibrosis poses a challenge even to the most experienced endoscopists [1]. In this context, saline-immersion therapeutic endoscopy (SITE) could offer a safer and more effective profile, joining its other advantages of improved visibility, intrinsic magnification, buoyancy (traction effect) and heat sink effect [7]. We describe our centre's experience on the efficacy and safety of SITE pocket creation method ESD (SITE-PCM-ESD) for fibrosed lesions.