Retrospective Cohort Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Jun 16, 2023; 15(6): 458-468
Published online Jun 16, 2023. doi: 10.4253/wjge.v15.i6.458
Multicenter evaluation of recurrence in endoscopic submucosal dissection and endoscopic mucosal resection in the colon: A Western perspective
Mike T Wei, Margaret J Zhou, Andrew A Li, Andrew Ofosu, Joo Ha Hwang, Shai Friedland
Mike T Wei, Margaret J Zhou, Andrew A Li, Joo Ha Hwang, Shai Friedland, Department of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, CA 94306, United States
Andrew Ofosu, Department of Gastroenterology, University of Cincinnati College of Medicine, Cincinnati, OH 45267, United States
Author contributions: Wei MT contributed to project conception, data collection, manuscript writing, data analysis, manuscript revision; Zhou MJ, Li AA and Ofosu A contributed to data analysis, manuscript revision; Hwang JH and Friedland S contributed to project conception, data collection, manuscript revision.
Institutional review board statement: This study was performed under the approval of the Institutional Review Board at Stanford University, Stanford, California, USA.
Informed consent statement: Because of retrospective study signed informed consent form is not needed.
Conflict-of-interest statement: Mike T. Wei: Consultant for Neptune Medical, AgilTx, Capsovision; Margaret Zhou and Andrew Ofosu: No conflicts; Andrew Li: Consultant for Neptune Medical; Joo Ha Hwang: Consultant for Olympus, Medtronic, Boston Scientific, Lumendi, Fujifilm, Noah Medical, Neptune Medical, and Micro-Tech; Shai Friedland: Consultant for Intuitive Surgical and Capsovision.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mike T Wei, MD, Clinical Assistant Professor, Department of Gastroenterology and Hepatology, Stanford University Medical Center, 300 Pasteur Drive, Palo Alto, CA 94306, United States. mtwei@stanford.edu
Received: February 20, 2023
Peer-review started: February 20, 2023
First decision: April 13, 2023
Revised: May 12, 2023
Accepted: May 31, 2023
Article in press: May 31, 2023
Published online: June 16, 2023
ARTICLE HIGHLIGHTS
Research background

Adoption of endoscopic submucosal dissection (ESD) has been slow in the United States, largely related to lack of experts, long training required and significant time for procedure compared to endoscopic mucosal resection (EMR).

Research motivation

In this study, we seek to evaluate our experience of ESD compared to EMR in California.

Research objectives

We evaluate ESD, knife-assisted endoscopic resection as well as EMR to identify factors for recurrence.

Research methods

This was a retrospective comparison performed at two tertiary centers within California between 2016 and 2020. Adult patients that received colonoscopy with endoscopic removal of a polyp at least 20 mm in size were included. Primary outcome of interest was recurrence on follow-up.

Research results

ESD achieved highest en bloc resection followed by knife-assisted endoscopic resection and EMR. On follow-up, recurrence rate was lowest in knife-assisted endoscopic resection (0.0%) and ESD (1.3%), while EMR had the highest recurrence rate (12.9%, P = 0.0017).

Research conclusions

In our study, we found that EMR had significantly higher recurrence compared to ESD or knife-assisted endoscopic resection.

Research perspectives

We have demonstrated efficacy of ESD in a Western population.