Observation On Therapeutic Evaluation Of Endoscopic Mucosal Resection And Endoscopic Submucosal Dissection For Precancerous Lesions Of Large Intestine

Objective: To evaluate the outcomes of endoscopic mucosal resection versusendoscopic submucosal dissection in the management of large intestine precancerouslesions. We collected and analysed all the117patients of large intestine precancerouslesions. Methods: Analysis of2010October to2011December Xinjiang two hospital andShanghai Zhongshan Hospital after endoscopic and pathological diagnosis ofprecancerous lesions of colorectal cancer patients, and accept ESD or EMR treatment.According to the different treatment, we divided the patients into two treatment groups:EMR group and ESD group to observe the situation of haemorrhage and perforation. Wecompared the rates of complete excision, bleeding, Perforation and local recurrence toobserve the therapeutic effects of EMR and ESD for early carcinoma of large intestine andprecancerous lesions. Results: There are all117patients and121lesions, and there are46lesions in group EMR and75lesions in group ESD. The diameter of lesions is from5mmto32mm with an average of14.3mm and the average diameter of lesions in EMR group is13.4mm, which in ESD group is16.6mm. and there is no significantly difference betweenthe two groups(P>0.05);The rates of complete excision is95.9%(116/121);the rates ofEMR group is89.1%(41/46),and in ESD group is100%(75/75), and it is significantlydifferent between the two groups (P <0.05); Bleeding average rate is17.4%(21/121),inEMR group is10.9%(5/46) and in ESD group is21.3%(16/75) and it is significantlydifferent between the two groups (P <0.05); Perforation average rate is5.0%(6/121), inEMR group is2.2%(1/46) and in ESD group is6.7%(5/75) and it is significantly differentbetween the two groups (P <0.05);We followed-up121patients. Average local recurrencerate is3.3%(4/121), in EMR group is6.5%(3/46) and in ESD group is1.3%(1/75) and it is significantly different between the two groups (P <0.05).Conclusion: ESD showedbetter effective compared with EMR. But had higher rates of bleeding complicationsalthough most of the bleeding are in control, and the perforation rate is higher.