Endoscopic submucosal dissection for premalignant lesions and noninvasive early gastrointestinal cancers

Table 1 Paris classification according to the endoscopic imaging of lesions

	Ia	IIa	IIb	IIa + IIc
Stomach	-	141		10
Small bowel	-	3	-	1
Colon	-	122	-	133
Esophagus	1	51	-	1

¹Two cases are submucosal;

²Nine granular type lateral spreading tumor(LST);

³Seven pseudo-depressed type LST.

Table 2 En bloc, piecemeal, complete, incomplete resection rates, median follow up and recurrence rates

	En bloc res. rate	Piecemeal res. rate	Complete res. rate	Incomplete res. rate	Median follow-up (mo)	Local recurrence
Esophagus	7/7 (100%)	0	7/7 (100%)	0	15	0
Stomach	22/24 (91.7%)	2/24 (8.3%)	23/24 (95.8%)	1/24 (4.1%)	11.8	1
Small intestine and colon	26/29 (89.7%)	3/29 (10.3%)	28/29 (96.5%)	1/29 (3.4%)	12.5	0
Total	55/60 (91.6%)	5/60 (8.3%)	58/60 (96.6%)	2/60 (3.3%)	12.51	1/58 (1.7%)1

¹Two patients who underwent surgery were excluded. Res: Resection.

Table 3 Esophageal endoscopic submucosal dissection cases

Location	Number	Histology (n)
Proximal esophagus	1	Granular cell tumor (1)
Middle esophagus	2	Granular cell tumor (2)
Distal esophagus	4	GIST (1)
		HGD-A (2)
		Leiomyoma (1)
Specimen size (median)		2.34 cm² (1.5-3 cm2)
Procedure time (median)		50.5 min (21.8 min/cm²)

GIST: Gastrointestinal stromal tumor; HGD-A: Adenoma with high grade dysplasia.

Table 4 Gastric endoscopic submucosal dissection cases

Location	Number	Histology (n)
Cardia	1	HGD (TVA) (1)
Corpus	3	NET (3)
Antrum	20	HGD-A (11)
		LGD-A (4)
		NET (1)
		EGC (2)
		GIST (1)
		Leiomyoma (1)
Specimen size (median)		3.25 cm² (1.5-12 cm²)
Procedure time (median)		90.4 min (27.8 min/cm²)

HGD: High grade dysplasia; NET: Neuroendocrine tumor; HGD-A: Adenoma with high grade dysplasia; LGD-A: Adenoma with low grade dysplasia; EGC: Early gastric cancer; LGD: Low grade dysplasia; GIST: Gastrointestinal stromal tumor; TVA: Tubulovillous adenoma.

Table 5 Colonic and intestinal endoscopic submucosal dissection cases

Location	Number	Histology (n)
Duodenal bulb	3	HGD (TVA) (2)
		NET (1)
Terminal ileum	1	NET (1)
Cecum	1	HGD (TVA) (1)
Transverse colon	3	HGD (TVA) (2)
		ECC (1)
Sigmoid colon	4	HGD (TVA) (3)
		LGD-TA (1)
Rectum	17	ECC (4)
		HGD (9 TVA, 2 TA)
		LGD-TA (1)
		NET (1)
Specimen size (median)		8.61 cm2 (1.5-25 cm²)
Procedure time (median)		158 min (18.3 min/cm²)

HGD: High grade dysplasia; NET: Neuroendocrine tumor; TA: Tubular adenoma; ECC: Early colonic cancer; LGD: Low grade dysplasia; TVA: Tubulovillous adenoma.

Table 6 Complications with regard to location and diagnosis

	n	Diagnosis	Minor bleeding	Major bleeding	Perforation
Esophagus	7	3 granular cell tumor
		1 GIST
		2 Premalignant lesions
		1 Leiomyoma
Stomach	24	4 NETs	4	2	1
		2 EGC	2
		18 Premalignant lesions
Small intestine	4	2 Premalignant lesions
		2 NETs
Colon	25	5 ECCs	3	1	1
		19 Premalignant lesions	4		3
		1 NETs
Total	60		13 (21.7%)	3 (5%)	5 (8.3%)

GIST: Gastrointestinal stromal tumor; NET: Neuroendocrine tumor; EGC: Early gastric cancer; ECC: Early colorectal cancer.