Surgery Versus Endoscopic Mucosal Resection Versus Endoscopic Submucosal Dissection for Large Polyps

Making Sense of When to Use Which Approach

Research output: Contribution to journalReview article

Abstract

Endoscopic resection for large colorectal lesion is effective and cost-saving than surgery. Piecemeal resections are often effective if applied meticulously but endoscopic submucosal dissection (ESD) allows meritorious removal of large lesions in one piece. For rectal lesions, transanal endoscopic microsurgery or transanal minimally invasive surgery offers more radical transmural resection but ESD is also effective for removal of complex rectal lesions. Surgical resection with lymph node dissection is the gold standard for invasive cancer; however, the management of low-risk early-stage colorectal cancer is worth debating. Treatment selection for large colorectal lesions is discussed based on lesion factor and treatment outcomes.

Original languageEnglish (US)
Pages (from-to)675-685
Number of pages11
JournalGastrointestinal Endoscopy Clinics of North America
Volume29
Issue number4
DOIs
StatePublished - Oct 1 2019

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Polyps
Minimally Invasive Surgical Procedures
Risk Management
Lymph Node Excision
Colorectal Neoplasms
Costs and Cost Analysis
Neoplasms
Endoscopic Mucosal Resection
Transanal Endoscopic Microsurgery

Keywords

  • EMR (endoscopic mucosal resection)
  • ESD (endoscopic submucosal dissection)
  • Large colon polyps
  • TAMIS (transanal minimally invasive surgery)
  • TEMS (transanal endoscopic microsurgery)

ASJC Scopus subject areas

  • Gastroenterology

Cite this

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title = "Surgery Versus Endoscopic Mucosal Resection Versus Endoscopic Submucosal Dissection for Large Polyps: Making Sense of When to Use Which Approach",
abstract = "Endoscopic resection for large colorectal lesion is effective and cost-saving than surgery. Piecemeal resections are often effective if applied meticulously but endoscopic submucosal dissection (ESD) allows meritorious removal of large lesions in one piece. For rectal lesions, transanal endoscopic microsurgery or transanal minimally invasive surgery offers more radical transmural resection but ESD is also effective for removal of complex rectal lesions. Surgical resection with lymph node dissection is the gold standard for invasive cancer; however, the management of low-risk early-stage colorectal cancer is worth debating. Treatment selection for large colorectal lesions is discussed based on lesion factor and treatment outcomes.",
keywords = "EMR (endoscopic mucosal resection), ESD (endoscopic submucosal dissection), Large colon polyps, TAMIS (transanal minimally invasive surgery), TEMS (transanal endoscopic microsurgery)",
author = "Norio Fukami",
year = "2019",
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AB - Endoscopic resection for large colorectal lesion is effective and cost-saving than surgery. Piecemeal resections are often effective if applied meticulously but endoscopic submucosal dissection (ESD) allows meritorious removal of large lesions in one piece. For rectal lesions, transanal endoscopic microsurgery or transanal minimally invasive surgery offers more radical transmural resection but ESD is also effective for removal of complex rectal lesions. Surgical resection with lymph node dissection is the gold standard for invasive cancer; however, the management of low-risk early-stage colorectal cancer is worth debating. Treatment selection for large colorectal lesions is discussed based on lesion factor and treatment outcomes.

KW - EMR (endoscopic mucosal resection)

KW - ESD (endoscopic submucosal dissection)

KW - Large colon polyps

KW - TAMIS (transanal minimally invasive surgery)

KW - TEMS (transanal endoscopic microsurgery)

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