ENDOSCOPIC SUBMUCOSAL DISSECTION FOR EARLY COLORECTAL NEOPLASIA: INITIAL EXPERIENCE FROM A PUBLIC REFERRAL SERVICE

Introduction Endoscopic resection is a treatment option for both malignant and non-malignant colorectal neoplasms. Endoscopic submucosal dissection (ESD) allows en bloc resection, but the experience with this technique for colorectal lesions is still limited in Latin America, especially in public centers.

Objective To describe the initial experience of a Brazilian public coloproctology service in the indication, performance, and follow-up of patients with colorectal lesions eligible for endoscopic submucosal dissection (ESD).

Method This is a retrospective, single-center study, which included patients with colorectal lesions suitable for treatment using the endoscopic submucosal dissection technique. Patients of both sexes, aged over 18 years, from a public referral center between 2020 and 2024, were selected. Epidemiological, colonoscopic, and histopathological data were retrieved from the hospital's digital system and tabulated in Excel for analysis.

Results 12 patients eligible for endoscopic submucosal dissection were treated by the team during the referred period. The average waiting time between diagnosis and treatment was 242 days (SD 120). The average size of the lesions was 41.08 mm (SD 21). Three cases (25%) required surgical conversion. All patients who required surgical conversion had deep submucosal invasion. In the remaining cases, the treatment was curative, corresponding to 72% of the cohort. No deaths occurred. Ten patients underwent colonoscopic follow-up with no evidence of tumor recurrence, and two patients are awaiting control endoscopic examination.

Conclusion Although the waiting time from diagnosis to treatment was long, endoscopic therapeutic success was achieved in most cases.

No conflict of interest has been declared by the author(s).

Publication History

Article published online:
25 April 2025