Potential perioperative advantage of XXXX versus laparoscopy-assisted colectomy.

@entity1 @entity548 @entity5 @entity86 @entity158 @entity14 @entity3 @entity652 @entity298 @entity1851
BACKGROUND: Endoscopic submucosal dissection (ESD) has recently provided a new treatment strategy for large @entity14 , as an alternative to laparoscopy-assisted colectomy (LAC). Prospective comparative data on the perioperative course of ESD vis-  -vis LAC are scarce. METHODS: We prospectively evaluated the perioperative course of colorectal ESD in 300 @entity1 . We evaluated en bloc and curative resection, procedure duration, postoperative parameters [white blood cell count (WBC), @entity1851 ( @entity1851 ), and hemoglobin], @entity158 , recovery duration (time to achieve full mobilization, normal diet, and length of hospitalization), and complications. We also prospectively evaluated 190 @entity1 undergoing LAC as a control group. RESULTS: The median size of the lesions was 30  mm for ESDs (LACs: 20  mm). The median procedure time was 90  min for ESDs (LACs: 185  min). @entity86 was reported in 4  % of ESDs (LACs: 54  %). Only 4  % of ESDs required analgesia (LACs: 61  %). Between the preoperative period and postoperative day 1, the mean difference in WBC and @entity1851 was +1,300/ l for ESDs (LACs: +3,100/ l), and +0.91  mg/dl for ESDs (LACs: +3.96  mg/dl), respectively. A >= 2  g/dl decrease in hemoglobin was observed in 5  % of ESDs (LACs: 30.0  %). Complications were seen in 7  % of ESDs (LACs: 15  %). The rate of delayed @entity548 and perforation was 5 and 1.7  % of ESDs, respectively. Although only one of them required laparotomy for @entity298 caused by delayed perforation, others could be managed endoscopically. Additional LAC was required in 16 ESDs due to redefined risk for lymph node @entity3 . The median hospital stay was 5  days for ESDs (LACs: 10  days). These were consecutive @entity1 with prospective data collection. CONCLUSIONS: Colorectal ESD is effective, minimally invasive and safe in terms of periperative clinical course. Colorectal ESD provides advantages for treatment of large @entity652 and @entity5 with no risk of lymph node @entity3 .
