Published online Jul 21, 2016. doi: 10.3748/wjg.v22.i27.6268
Peer-review started: March 4, 2016
First decision: April 1, 2016
Revised: April 13, 2016
Accepted: May 4, 2016
Article in press: May 4, 2016
Published online: July 21, 2016
AIM: To evaluate the feasibility and safety of endoscopic submucosal dissection (ESD) for lower rectal lesions with hemorrhoids.
METHODS: The outcome of ESD for 23 lesions with hemorrhoids (hemorrhoid group) was compared with that of 48 lesions without hemorrhoids extending to the dentate line (non-hemorrhoid group) during the same study period.
RESULTS: Median operation times (ranges) in the hemorrhoid and non-hemorrhoid groups were 121 (51-390) and 130 (28-540) min. The en bloc resection rate and the curative resection rate in the hemorrhoid group were 96% and 83%, and they were 100% and 90% in the non-hemorrhoid group, respectively. In terms of adverse events, perforation and postoperative bleeding did not occur in both groups. In terms of the clinical course of hemorrhoids after ESD, the rate of complete recovery of hemorrhoids after ESD in lesions with resection of more than 90% was significantly higher than that in lesions with resection of less than 90%.
CONCLUSION: ESD on lower rectal lesions with hemorrhoids could be performed safely, similarly to that on rectal lesions extending to the dentate line without hemorrhoids. In addition, all hemorrhoids after ESD improved to various degrees, depending on the resection range.
Core tip: Recently, the feasibility and safety of endoscopic submucosal dissection (ESD) have been reported from different countries. However, ESD for lesions extending to the dentate line is technically difficult due to the anatomical features. This paper showed ESD on lower rectal lesions with hemorrhoids was feasible and safe, similarly to that on rectal lesions extending to the dentate line without hemorrhoids and all hemorrhoids after ESD improved to various degrees, depending on the resection range.