Feasibility and Outcomes of Endoscopic Submucosal Dissection for Colorectal Premalignant and Early-Stage…

Cohort studyGastro hep advances· 2026

Feasibility and Outcomes of Endoscopic Submucosal Dissection for Colorectal Premalignant and Early-Stage Malignant Lesions at a Community Hospital Serving Rural Population.

Siddharth B Javia, Whitney Reid, Seth Crockett, Gregory A Coté

Colon & Rectal SurgeryCohort studyTreatmentQ2IF 1.8

Endoscopic submucosal dissection succeeded in most colorectal lesions at a rural community hospital.

Feasibility and Outcomes of Endoscopic Submucosal Dissection for Colorectal Premalignant and Early-Stage Malignant Lesions at a Community Hospital Serving Rural Population.

Siddharth B Javia … Gregory A Coté

Gastro hep advances · 2026 · Q2 in Gastroenterology

Background

Shortage of specialists and distance to facility are known barriers associated with reduced colorectal cancer screening in rural America.

Purpose

We aim to study the feasibility and clinical outcomes of an endoscopic submucosal dissection (endoscopic submucosal dissection) at a rural US health system.

Methods

Data and clinical outcomes were reviewed for consecutive patients who underwent attempted endoscopic submucosal dissection for colorectal premalignant and early-stage malignant lesions from February 2021 to January 2024.

n = 82 lesions

Results

90.2%

standard technique alone removed most polyps without needing added rescue methods

n = 82 lesions

More results

Forty-four (47.8%) lesions were in the right colon.

For those who underwent standard endoscopic submucosal dissection without hybrid technique, resection rates were en bloc 81 (98.7%), R0 62 (75.6%), and curative 58 (70.7%).

Adverse events occurred in 4 (4.8%).

More results

Final pathology showed tubular or tubulovillous adenoma in 51 (62.2%), sessile serrated lesion in 2 (2.4%), high-grade dysplasia in 14 (17.1%), and adenocarcinoma in 15 (18.3%), with adenocarcinomas being staged T1 with low-risk features in 9 (11%) and ≥T1 with high-risk features in 6 (7.3%).

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Conclusion

Endoscopic submucosal dissection can be introduced at a community hospital with a high level of safety and efficacy.

Feasibility and Outcomes of Endoscopic Submucosal Dissection for Colorectal Premalignant and Early-Stage Malignant Lesions at a Community Hospital Serving Rural Population.

Feasibility and Outcomes of Endoscopic Submucosal Dissection for Colorectal Premalignant and Early-Stage Malignant Lesions at a Community Hospital Serving Rural Population.

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