Endoscopic management of early colorectal cancer: comparison between piecemeal mucosectomy and hybrid submucosal dissection in a single tertiary medical centre in northern italy

Gastrointestinal early neoplasm exceeding 20 mm in diameter are often be removed with piecemeal endoscopic mucosal resection (PEMR), but it seems to increase the risk of recurrence. Endoscopic submucosal dissection (ESD) is an alternative procedure to enable en-bloc resection with a lower local recurrence but, its technical difficulties, its longer procedure time and increased risk of perforation limit its widespread. To overcome these issues it has been developed a new hybrid technique: hybrid ESD (ESD-H), a simplified ESD (used also as a rescue procedure in difficult colorectal ESD cases). The main aim of our study was to analyze recurrence rate lesions after removing early stage of colorectal lesions ≥30 mm removal in a single, tertiary-care, centre employing ESD-H or PEMR. Safety, duration of procedures were analyzed too.