Journal article
Clinical Outcomes of Endoscopic Submucosal Dissection for Residual Neoplasia After Incomplete Resection of Large Non-Pedunculated Colorectal Polyps: A Large Multicenter Propensity Match Study
Gastrointestinal endoscopy, Vol.103(3), pp.532-540
03/2026
DOI: 10.1016/j.gie.2025.07.026
PMID: 40706906
Abstract
Data on endoscopic submucosal dissection (ESD) for residual neoplasia after incomplete resection (ER) of large non-pedunculated colorectal polyps (LNPCPs) remains scarce. We aimed to evaluate and compare outcomes of ESD in treatment naïve (control) lesions vs. those with prior failed ER.
Multicenter propensity-score (PS) match study of ESDs performed for LNPCPs between January 2021 to September 2024. The following covariates were used for PS calculation: age, sex, and lesion characteristics (size, location, morphology, histology). Endpoints included: rates of en-bloc and R0 resection, adverse events and neoplasia recurrence on surveillance.
A total of 1447 consecutive patients underwent ESD during the study period. PS match resulted in the selection of 361 (control) and 184 (prior failed ER) strictly matched 2:1 pairs. En-bloc and R0 resection rates were similar between the control and prior failed ER arms: 91.7% vs 89.7%; p=.44 and 80.9% vs. 81.0%; p=.98, respectively. There was no difference in the rate of perforation between the control and prior failed ER arms (4.7% vs. 4.4%; p=1.00), whereas there was non-statistically significant trend towards higher delayed bleeding in the prior failed ER group (1.63% vs. 0.83%, relative risk: 1.96; p=0.40). Neoplasia recurrence on surveillance was 3.6% in the control and 5.8% in the prior failed ER group (p=0.32).
ESD can be performed safely and effectively as a salvage therapy after failed attempt at ER of LNPCPs. ESD may be selectively considered as part of our endoscopic armamentarium for the management of these difficult-to-treat lesions. support current guideline endorsed indications for ESD for the treatment of residual neoplasia after incomplete ER.
Details
- Title: Subtitle
- Clinical Outcomes of Endoscopic Submucosal Dissection for Residual Neoplasia After Incomplete Resection of Large Non-Pedunculated Colorectal Polyps: A Large Multicenter Propensity Match Study
- Creators
- Ernesto Robalino Gonzaga - Gastroenterology and Hepatology, AdventHealth Medical Group, Orlando, FLYiyang Zhang - AdventHealth East OrlandoAbdul S Mohammed - Gastroenterology and Hepatology, AdventHealth Medical Group, Orlando, FLBaha Aldeen Bani Fawwaz - Gastroenterology and Hepatology, AdventHealth Medical Group, Orlando, FLAimen Farooq - AdventHealth East OrlandoNihal I Khan - AdventHealth OrlandoWilliam W King - University of FloridaSalmaan A Jawaid - Baylor College of MedicineMohamed O Othman - Baylor University Medical CenterMai A Khalaf - Baylor College of MedicineShai Friedland - Hartford HospitalAbel Joseph - Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Palo Alto, CAJoo Ha Hwang - Stanford UniversityA Aziz Aadam - Northwestern UniversityMark A Solinski - Northwestern UniversityRobert Bechara - Queen's UniversityJade Marhaba - Stony Brook University HospitalLionel S D'Souza - Stony Brook University HospitalAhmed Saeed - HCA Midwest DivisionSherif A Andrawes - Northwell HealthYutaka Tomizawa - University of WashingtonAqsa Khan - Mayo Clinic in ArizonaNeil Sharma - Parkview HealthFrances Dang - University of California, IrvineJason B Samarasena - University of California, IrvineSayaka Nagao - Memorial Sloan Kettering Cancer CenterMakoto Nishimura - Memorial Sloan Kettering Cancer CenterPiraka Cyrus - Henry Ford HospitalZuchelli Tobias - Henry Ford HospitalSaurabh Chandan - AdventHealth OrlandoAbdullah Abbasi - University of Iowa, Internal MedicineSagar Pathak - Center for Interventional Endoscopy, AdventHealth, Orlando, FLNatalie Cosgrove - Center for Interventional Endoscopy, AdventHealth, Orlando, FLJain Deepanshu - AdventHealth OrlandoArain M Mustafa - AdventHealth OrlandoKambiz Kadkhodayan - Center for Interventional Endoscopy, AdventHealth, Orlando, FLMaham Hayat - AdventHealth OrlandoMuhammad K Hasan - Center for Interventional Endoscopy, AdventHealth, Orlando, FLHiroyuki Aihara - Brigham and Women's HospitalPeter V Draganov - University of FloridaDennis Yang - AdventHealth Orlando
- Resource Type
- Journal article
- Publication Details
- Gastrointestinal endoscopy, Vol.103(3), pp.532-540
- DOI
- 10.1016/j.gie.2025.07.026
- PMID
- 40706906
- NLM abbreviation
- Gastrointest Endosc
- ISSN
- 0016-5107
- eISSN
- 1097-6779
- Language
- English
- Electronic publication date
- 07/22/2025
- Date published
- 03/2026
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984847632602771
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