Zhu WW, Yang X, Yang Z, Liu J, Jia W, Chen XL, Tian Y, Gao TJ, Sun GY, Zhang M, Liu CH, Yu JY, Huo JF, Zhao HN. Endoscopic treatment of large colorectal lesions: A retrospective analysis of efficacy and safety. World J Gastrointest Endosc 2025; 17(10): 110116 [DOI: 10.4253/wjge.v17.i10.110116]
Corresponding Author of This Article
Zhuo Yang, Chief Physician, Professor, Department of Endoscopy, General Hospital of Northern Theater Command, No. 83 Wenhua Road, Shenhe District, Shenyang 110011, Liaoning Province, China. yangzhuocy@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Oct 16, 2025 (publication date) through Oct 19, 2025
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Journal Information of This Article
Publication Name
World Journal of Gastrointestinal Endoscopy
ISSN
1948-5190
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Zhu WW, Yang X, Yang Z, Liu J, Jia W, Chen XL, Tian Y, Gao TJ, Sun GY, Zhang M, Liu CH, Yu JY, Huo JF, Zhao HN. Endoscopic treatment of large colorectal lesions: A retrospective analysis of efficacy and safety. World J Gastrointest Endosc 2025; 17(10): 110116 [DOI: 10.4253/wjge.v17.i10.110116]
Wen-Wen Zhu, Xin Yang, Zhuo Yang, Jiao Liu, Wen Jia, Xu-Lin Chen, Ye Tian, Teng-Jiao Gao, Guo-Yao Sun, Meng Zhang, Jing-Yi Yu, Jian-Feng Huo, Huan-Nan Zhao, Department of Endoscopy, General Hospital of Northern Theater Command, Shenyang 110011, Liaoning Province, China
Chuan-Hong Liu, Department of Outpatient, The First Cadre’s Sanitarium of Liaoning Military Command, Shenyang 110016, Liaoning Province, China
Co-first authors: Wen-Wen Zhu and Xin Yang.
Author contributions: Zhu WW and Yang X participated in the conception, design of the study, involved in the acquisition, analysis, and interpretation of data, they contributed equally to this manuscript and are co-first authors; Zhu WW wrote the manuscript; Yang Z, Liu J and Jia W accessed and verified the study data; Chen XL, Tian Y, Gao TJ and Sun GY were responsible for patient screening, enrollment and collection of clinical data; Zhang M, Yu JY, Huo JF, Zhao HN were responsible for study supervision, manuscript revision and submission. All authors critically reviewed and provided final approval of the manuscript; and all authors were responsible for the decision to submit the manuscript for publication.
Supported by the Shenyang Science and Technology of Liaoning Province, No. 22-321-32-15.
Institutional review board statement: This study was approved by the Ethics Committee of General Hospital of Northern Theater Command, No. Y (2025) 073.
Informed consent statement: The need for patient consent was waived due to the retrospective nature of the study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhuo Yang, Chief Physician, Professor, Department of Endoscopy, General Hospital of Northern Theater Command, No. 83 Wenhua Road, Shenhe District, Shenyang 110011, Liaoning Province, China. yangzhuocy@163.com
Received: May 30, 2025 Revised: June 17, 2025 Accepted: September 18, 2025 Published online: October 16, 2025 Processing time: 140 Days and 4.5 Hours
Abstract
BACKGROUND
The incidence and mortality of colorectal cancer continue to rise. For early-stage colorectal cancer, endoscopic resection has become a preferred or important treatment option due to its significant advantages in operative time, extent of trauma, and medical costs. However, increasing lesion diameter significantly elevates the technical difficulty of endoscopic resection. Currently, robust evidence-based evidence regarding the upper size limit for safely and effectively resecting lesions endoscopically remains lacking.
AIM
To evaluate the efficacy and safety of endoscopic resection for colorectal lesions ≥ 30 mm in diameter.
METHODS
This retrospective study reviewed data from 102 patients who underwent endoscopic resection for colorectal lesions measuring ≥ 30 mm in diameter at General Hospital of Northern Theater Command between January 2023 and July 2024.
RESULTS
Among 102 patients who underwent endoscopic resection, 99 received endoscopic submucosal dissection and 3 underwent endoscopic full-thickness resection. Four patients (3.9%) required conversion to surgical radical resection postoperatively. All patients exhibited favorable wound healing at the resection sites, and no long-term complications were observed during the 3-month postoperative colonoscopy follow-up. The primary perioperative complication was post-endoscopic submucosal dissection electrocoagulation syndrome (PEECS) (24/102, 23.5%). Multivariate analysis identified lesion location in the transverse colon as an independent risk factor for PEECS occurrence (odds ratio = 6.734, 95% confidence interval: 1.623-27.945, P = 0.009).
CONCLUSION
Large colorectal lesion diameter does not constitute an absolute contraindication to endoscopic resection. Experienced endoscopic centers can achieve complete resection with a favorable efficacy and safety profile. Notably, lesion location in the transverse colon is identified as an independent risk factor for PEECS.
Core Tip: This single-center retrospective study evaluated the efficacy and safety of endoscopic resection for large colorectal lesions. Results demonstrated that lesion diameter does not constitute an absolute contraindication to endoscopic therapy, with complete resection achievable in experienced centers. Critically, lesion location in the transverse colon was identified as an independent risk factor for post-endoscopic submucosal dissection electrocoagulation syndrome.
