Feasibility of Endoscopic Submucosal Dissection: A New Technique for En Bloc Resection of a Large Superficial Tumor in the Colon and Rectum

Table 3

Indication of endoscopic submucosal dissection (ESD) for colorectal tumor.

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(1) Lesions that were larger than 20 mm in diameter in which en bloc resection using snare EMR is difficult, although it is indicative for endoscopic treatment

 (i) Non-granular LST, particularly those of the pseudo-depressed type

 (ii) Lesions with Vi type pit pattern

 (iii) Carcinoma with submucosal infiltration

 (iv) Large depressed type lesion

 (v) Large lesions with elevated type suspected to be cancer^†

(2) Mucosal lesions with fibrosis caused by prolapse due to biopsy or peristalsis of the lesions

(3) Sporadic localized tumors in chronic inflammation such as ulcerative colitis

(4) Local residual early cancer after endoscopic resection

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^†Including granular LST that consisted of large nodules.
EMR: endoscopic mucosal resection, LST: laterally spreading tumor.