Endoscopic mucosal resection versus endoscopic submucosal dissection for early colorectal cancer and precursor lesions: a retrospective study

To investigate the efficacy and safety of EMR versus ESD for early colorectal cancer and precursor lesions.

Study Design: Single-center retrospective study enrolling 101 patients with early CRC or precursor lesions.
Methods: Patients underwent EMR or ESD based on lesion characteristics. Outcomes measured included operative time, resection rates, and complications.

For lesions ≥20 mm, ESD achieved higher en bloc (91.2% vs. 71.4%, p = 0.036), complete (85.3% vs. 62.9%, p = 0.034), and curative (82.4% vs. 60.0%, p = 0.041) resection rates than EMR.
Outcomes were similar for lesions <20 mm.
Right-colon ESD had a significantly higher complication rate than EMR (40.0% vs. 6.3%, p = 0.046).
At 12-month follow-up, recurrence was 2.1% for ESD and 11.3% for EMR (p = 0.072).

ESD provides higher resection rates for larger lesions but has higher complication rates, particularly in the right colon.

For lesions ≥20 mm, ESD is preferred, especially for lesions ≥30 mm, while EMR is preferred for lesions <20 mm.