Endoscopic submucosal dissection of colorectal neoplasia located on the suture line of anastomosis

Joichiro Horii, Toshio Uraoka, Osamu Goto, Hiroyuki Ishii, Masayuki Shimoda, Naohisa Yahagi

Research output: Contribution to journalArticle

2 Citations (Scopus)


Although endoscopic submucosal dissection (ESD) can remove gastrointestinal neoplasia even with severe fibrosis into the submucosa, the safety and efficacy of ESD for colorectal neoplasia (CRN) located on the suture line of anastomosis (SLA) has not been assessed. The aim of this study was to evaluate the feasibility of ESD for CRN located on the SLA, performed by a highly skilled endoscopist. Three consecutive patients with CRN located on the SLA were treated with ESD. In all cases, ESD was safely performed without any adverse events. The median tumor size of the resected CRN was 30 mm (range 12-75 mm) and the median procedure time was 150 min (range 50-150 min). Curative resection was achieved in two cases without local recurrence during a 12-month observation period. In one case, the CRN were resected in an almost en bloc fashion, but a decision was made to spare the edge of the CRN that was directly on the SLA in order to avoid delayed perforation, and this edge was instead removed with hemostatic forceps. Although the surveillance colonoscopy revealed a small residual neoplasia, it was curatively treated by endoscopically. In all cases, ESD managed to avoid the need for repetitive surgery. This case series suggests the feasibility of ESD performed by a highly skilled endoscopist as a curative treatment for the CRN located on the SLA.

Original languageEnglish
Pages (from-to)290-294
Number of pages5
JournalClinical journal of gastroenterology
Issue number4
Publication statusPublished - 2014 Aug



  • Colorectal neoplasia
  • Endoscopic submucosal dissection
  • Suture line of anastomosis

ASJC Scopus subject areas

  • Gastroenterology

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