Predictors of Prolonged Rectal Endoscopic Submucosal Dissection
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Predictors of Prolonged Rectal Endoscopic Submucosal Dissection

Douglas K. Rex, MD, MASGE, reviewing Hihara D, et al. Gastrointest Endosc 2023 Apr 13.

In a Japanese experience of endoscopic submucosal dissection (ESD) performed on 483 rectal lesions over 23 years, a prolonged ESD was considered longer than 120 minutes.

Overall, 144 procedures were prolonged, with a mean procedure time of 203 minutes, compared with a mean procedure time of 78 minutes for ESD procedures not considered prolonged.

Predictors of prolonged procedures in a multivariate analysis included involvement of the dentate line, lesion size ≥50 mm, invasion depth T1b or deeper, and involvement of two-thirds or more of the circumference.

Douglas K. Rex, MD, FASGE

COMMENT

Rectal lesions with high-risk morphology for cancer are the most widely accepted indication for colorectal ESD. Some of these study results can help in scheduling an appropriate block of time for rectal ESD procedures.

Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.

CITATION(S)

Hihara D, Takamaru H, Sekiguchi M, et al. Factors associated with increased duration of endoscopic submucosal dissection for rectal tumors: a 22-year retrospective analysis. Gastrointest Endosc 2023 Apr 13. (Epub ahead of print) (https://doi.org/10.1016/j.gie.2023.04.005)

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