This study evaluated the efficacy of endoscopic submucosal dissection for residual/locally recurrent lesions in comparison with primary lesions. Method:  This retrospective case-control investigated 34 residual/locally recurrent

lesions and 384 primary lesions treated using endoscopic submucosal dissection. Tumor size, resected specimen size, procedure duration, en bloc resection rate, curative resection rate, histology, associated complications, and recurrence rate were compared between groups. Results:  Procedure duration tended to be longer (85 ± 53 min vs 73 ± 55 min) check details and tumors were significantly smaller (20 ± 13 mm vs 33 ± 20 mm; P < 0.001) in the residual/locally recurrent group, compared with primary lesions. Both groups showed similar percentages of en bloc (100% vs 97.4%) and curative resection (88.4% vs. 83.6%). Perforation rate was significantly higher in the residual/locally

C59 wnt mw recurrent group (14.7% vs 4.4%, P < 0.05). However, emergency surgery was only needed in 1 of 5 cases in the residual/locally recurrent group, with the remaining 4 cases conservatively managed using endoclips. Conclusions:  Endoscopic submucosal dissection for residual/locally recurrent lesions was curative and efficacy. This procedure could help to avoid surgical medchemexpress resection and frequent follow-up examinations in many patients. Conventional endoscopic mucosal resection (EMR) is

frequently performed for epithelial colorectal lesions, but residual/locally recurrent lesions may occur after endoscopic therapy and the rate of recurrence is reportedly 5.9–17%.1–4 Conventional therapy for residual/locally recurrent lesions involves repeated EMR and incineration by argon plasma coagulation (APC).5 Lesions that show sufficient elevation after injection or are small can either be resected with a snare or treated by incineration. These treatments, when successful, may be curative for residual/locally recurrent lesions. However, residual/locally recurrent lesions generally show severe fibrosis and a non-lifting sign. Repeated EMR following endoscopic diagnosis of residual/locally recurrent lesions is often unsuccessful and is technically difficult to perform due to submucosal fibrosis.6 If a lesion is large, performing additional EMR with a snare and incineration by APC is difficult. Such lesions often need repeated therapy, and some cases might need surgical resection. Incineration by APC also cannot provide histological specimens to confirm complete resection. Endoscopic submucosal dissection (ESD) has been a standard therapy for epithelial esophagogastric tumors, particularly in Japan.