Recurrence Rate and Short-Term Outcomes of Endoscopic Submucosal Dissection (ESD) Using Pocket Creation Method vs. Laparoscopic Surgery in Management of Colonic Lateral Spreading Tumor from Surgeons' Prospective

Alex Lik Hang Leung*, Chi Wai, Lau and Chung Ngai Tang

Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong, China

^*Correspondance to: Alex Lik Hang Leung, 

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Abstract:

Background: We aimed to compare the clinical outcomes of ESD using PCM versus laparoscopic
surgery in management of colonic LST.
Method: We conducted a retrospective comparative study of the management of colonic LST not
able to be removed by standard endoscopic methods. They either have undergone ESD with PCM or
laparoscopic surgeries including colectomy or colotomy and polypectomy. Patient’s demographics,
perioperative data were retrieved from a database. Patients with other concomitant procedures were
excluded.
Results: From 2008 to 2018, 42 and 41 patients have undergone ESD and laparoscopic surgeries
respectively. The demographic data and mean sizes of the LST in the two groups were similar.
Although ESD had significantly longer procedure time (141 ± 43 min vs. 115 ± 44 min, p=0.008),
but it had shorter hospital stay (4.7 ± 1.4 days vs. 8.9 ± 5.4 days, p<0.005). The ESD group had
a trend of lower complication rate (2/42 vs. 7/41, p=0.071) than laparoscopic group. The en-bloc
resection rate of ESD was 90.5% and the R0 resection rate was 83.3%. There was one postoperative
mortality in the laparoscopic group with no mortality in the ESD group (p=0.31).
Conclusion: In management of colonic LST, ESD with PCM due to its less invasiveness results in
less morbidities, shorter hospital stay than laparoscopic surgeries, even in a unit with low volume
of ESD.

Keywords:

Endoscopic Submucosal Dissection (ESD); Pocket creation method; Laparoscopic
surgery; Lateral spreading tumor

Cite the Article:

Leung ALH, Wai C, Lau, Tang CN. Recurrence Rate and Short-Term Outcomes of Endoscopic Submucosal Dissection (ESD) Using Pocket Creation Method vs. Laparoscopic Surgery in Management of Colonic Lateral Spreading Tumor from Surgeons' Prospective. World J Surg Surgical Res. 2020; 3: 1251..