A single-center study suggests that a saline-immersion/irrigation technique (SITE) combined with the pocket-creation method (PCM) can significantly improve outcomes in colorectal endoscopic submucosal dissection (ESD).
Key findings:
- High efficacy: R0 resection rate of 92.3% and curative resection rate of 90.6% for complex colorectal lesions ≥2 cm and rectal neuroendocrine tumors.
- Low recurrence: Only one local recurrence, successfully treated endoscopically.
- Strong safety profile: Adverse events occurred in 4.4% of cases, mainly intraprocedural perforations managed endoscopically.
- Patient-friendly:93.4% of procedures were performed under conscious sedation, with no procedures stopped due to patient discomfort.
Why it matters:
SITE-ESD improves visualization and procedural stability by replacing intraluminal gas with saline irrigation, enabling safer and more effective en bloc resection of complex lesions. The approach may reduce the need for general anesthesia and surgery while maintaining high curative outcomes.
Limitations:
Results are from a single center, follow-up was available for only 58.8% of patients, and resection speed was modest due to lesion complexity.
Bottom line:
SITE-ESD appears to be a safe, effective, and patient-centered enhancement to colorectal ESD, with the potential for wider adoption in advanced endoscopic practice.