Long‐term clinical outcomes of endoscopic submucosal dissection for colorectal neoplasia with or without the hybrid technique

• Published in: Colorectal disease 2020-12, Vol.22 (12), p.2008-2017
• Main Authors: Kang, DU, Park, JC, Hwang, SW, Park, SH, Yang, DH, Kim, KJ, Ye, BD, Myung, SJ, Yang, SK, Byeon, JS
• Format: Article
• Language: English
• Subjects: Clinical outcomes; Dissection; endoscopic submucosal dissection; Endoscopy; hybrids; Medical records; Metastases; Metastasis; Multivariate analysis; recurrence; Risk factors; Tumors
• ISSN: 1462-8910; 1463-1318
• DOI: 10.1111/codi.15339

Aim The main aim of this study was to compare the long‐term outcome of a conventional colorectal endoscopic submucosal dissection (ESD) in which submucosal dissection was continued throughout until the completion of resection (ESD‐T) to hybrid endoscopic submucosal dissection (ESD‐H) in the colorectum. Method Medical records of 836 colorectal neoplasia patients treated by ESD‐T or ESD‐H were reviewed. ESD‐H was defined as colorectal ESD with additional snaring in the final stage of the procedure. Primary outcomes were the overall and metastatic recurrence rates. Secondary outcomes were short‐term outcomes such as the en bloc resection rate, procedure time and adverse events. Results The overall recurrence rate was higher in the ESD‐H than in the ESD‐T group (5.7% vs 0.7%, P = 0.001). The metastatic recurrence rate showed no significant difference between these groups (1.4% vs 1.4%, P = 1.000). Multivariate analysis revealed that a failed en bloc resection (hazard ratio 24.097; 95% CI 5.446–106.237; P