ESD for Colorectal LSL Using a Selective Strategy - a Prospective Cohort Study

Summary

Colonic Laterally spreading lesions (LSL) =\> 20mm are at high risk to progress to cancer. Overt stigmata of submucosal invasive cancer (SMIC) has been well characterized and includes ulceration and surface pit pattern changes as per the Kudo classification of type V. In a recent report, risk factors for LSL with SMIC and no overt stigmata (i.e. covert SMIC) were described. Resection of these lesions 'en-bloc' can allow for better histological staging and potentially reduce the need for surgical resection.

Eligibility

Inclusion Criteria:

* All patients referred for colorectal resection of large laterally spreading lesions in colon.
* Can give informed consent to trial participation

Exclusion Criteria:

* Previous resection or attempted resection of target adenoma lesion
* Endoscopic appearance of invasive malignancy
* Age less than 18 years
* Pregnancy
* Active Inflammatory colonic conditions (e.g. inflammatory bowel disease)
* Use of anticoagulant or antiplatelet agents other than aspirin outside of internationally recognised guidelines
* American Society of Anesthesiology (ASA) Grade IV-V

Conditions3

Browse More Trials