Endoscopic submucosal dissection for the treatment of XXXX 7-16  mm in diameter.

@entity5 @entity1 @entity3 @entity548
OBJECTIVE: Small @entity5 (<10  mm) are often removed via endoscopic submucosal dissection (ESD). However, the use of ESD for @entity5 of an intermediate size (7-16  mm) is less well documented. This study aimed to evaluate the efficacy and safety of ESD compared with endoscopic mucosal resection using a cap (EMR-C) for the treatment of 7-16-mm rectal carcinoids. MATERIAL AND METHODS: From September 2007 to August 2012, 55 @entity1 with large @entity5 were treated by EMR-C (30 cases) or ESD (25 cases). The en bloc resection rate, pathological complete response (pCR) rate, procedure time, and incidence rates of complications, local recurrence, and distant @entity3 were evaluated. RESULTS: The basic and clinical characteristics of the @entity1 in the two groups did not differ significantly (p   >   0.05). The mean procedure time was longer for ESD than EMR-C (24.79        4.89 vs. 9.52        2.14  min, p   <   0.001). The rates of en bloc resection and pCR were higher with ESD than with EMR-C (100 vs. 83.33  %, and 100 vs. 70.00  %, respectively). No @entity1 in the EMR-C group experienced complications. However, in the ESD group, two cases of perforation occurred, and one @entity1 experienced delayed @entity548 . These complications were successfully managed via endoscopical therapy. Five cases of local recurrence were detected after EMR-C, whereas no @entity1 experienced recurrence after ESD. CONCLUSIONS: Compared with EMR-C, ESD appears to be a more favorable therapeutic option for the treatment of @entity5 less than 16  mm in diameter based on improved rates of pCR and local recurrence.
