Comparison of endoscopic mucosal resection and endoscopic submucosal dissection in the treatment of flat neoplastic lesions in the rectum

Endoscopic submucosal dissection (ESD) is a method used for en bloc removal of colorectal lesions > 20 mm. A comparison of ESD and endoscopic mucosal resection (EMR) in the treatment of rectal flat neoplastic lesions is reported. A total of 27 and 30 patients were included in ESD and EMR group, respectively. En bloc resection was achieved in 21(78 %) vs. 2(7 %), (p < 0,005) while perforation not requiring surgery occurred in 3(11 %) vs. 0 (p= 0,099) and local residual neoplasia in 2(9 %) vs. 9 (41 %) cases (p = 0,017). There was no procedure related letality in either group. ESD seems to be a promising method for the treatment of rectal neoplastic lesions.