Endoscopic submucosal dissection vs laparoscopic colorectal resection for early XXXX .

@entity1 @entity548 @entity5 @entity5848 @entity14
AIM: To compare the short term outcome of @entity5848 ( @entity5848 ) with that of laparoscopic colorectal resection (LC) for the treatment of early @entity14 that are not amenable to conventional endoscopic removal. METHODS: This was a retrospective cohort study. The clinical data of all consecutive @entity1 who underwent @entity5848 for endoscopically assessed benign lesions that were larger than 2 cm in diameter from 2009 to 2013 were collected. These @entity1 were compared with a cohort of controls who underwent LC from 2005 to 2013. Lesions that were proven to be malignant by initial endoscopic biopsies were excluded. Mid and lower rectal lesions were not included because total mesorectal excision, which bears a more complicated postoperative course, is not indicated for lesions without histological proof of @entity5 . Both @entity5848 and LC were performed by the same surgical unit with a standardized technique. The @entity1 were managed according to a standard protocol, and they were closely monitored for complications after the procedures. All hospital records were reviewed, and the following data were compared between the @entity5848 and LC groups: @entity1 demographics, size and location of the lesions, procedure time, short-term clinical outcomes and pathology results. RESULTS: From 2005 to 2013, 65 @entity1 who underwent @entity5848 and 55 @entity1 who underwent LC were included in this study. The two groups were similar in terms of sex (P = 0.41) and American Society of Anesthesiologist class (P = 0.58), although @entity1 in the @entity5848 group were slightly older (68.6    9.4 vs 64.6    9.9, P = 0.03). @entity5848 could be accomplished with a shorter procedure time (113    66 min vs 153    43 min, P < 0.01) for lesions of comparable size (3.0    1.2 cm vs 3.4    1.4 cm, P = 0.22) and location (colon/rectum: 59/6 vs colon/rectum: 52/3, P = 0.43). @entity5848 appeared to be associated with a lower short-term complication rate, but the difference did not reach statistical significance (10.8% vs 23.6%, P = 0.06). In the LC arm, a total of 22 complications occurred in 13 @entity1 . A total of 7 complications occurred in the @entity5848 arm, including 5 perforations and 2 episodes of @entity548 . All perforations were observed during the procedure and were successfully managed by endoscopic clipping without emergency surgical intervention. @entity1 in the @entity5848 arm had a faster recovery than @entity1 in the LC arm, which included shorter time to resume normal diet (2 d vs 4 d, P = 0.01) and a shorter hospital stay (3 d vs 6 d, P < 0.01). CONCLUSION: @entity5848 showed better short-term clinical outcomes in this study. Further prospective randomized studies will be required to evaluate the efficacy and superiority of colorectal @entity5848 over LC.
