Efficacy and safety of endoscopic submucosal dissection for colorectal submucosal tumors

Objective To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) for colorectal SMTs. Methods In this retrospective study, 412 consecutive patients with colorectal SMTs who underwent ESD at Zhongshan Hospital of Fudan University from January 2008 to July 2014 were enrolled. Tumor histopathology, resection rate and complications were analyzed. Results Complete resection was achieved in 358 (86.9%) lesions. Adverse events occurred in 13 (3.2%) patients including bleeding and perforation. Multivariate analysis showed that the SMTs in the colon(OR=0.460, 95%CI: 0.232-0.911, P=0.014) and number of ESD procedures for colorectal SMTs(OR=0.421, 95%CI: 0.211-0.837, P=0.026)were independent risk factors for non-complete resection. Moreover, SMTs in the colon (OR=0.253, 95%CI: 0.067-0.957, P=0.043), tumors in the muscularis propria (OR=5.459, 95%CI: 1.162-25.638, P=0.032)and number of ESD procedures for colorectal SMTs(OR=0.198, 95%CI: 0.058-0.674, P=0.010)were independent risk factors for adverse events. Conclusion ESD is safe and effective for resection of colorectal SMTs. Tumor location and the experience of endoscopists may influence the complete resection rate and the development of adverse events.