Aims
This study aims to evaluate the safety,efficacy, and learning curve of SSD in colonicpolypectomy, particularly amongendoscopists new to ESD techniques.
Methods
A retrospective multicenter study wasconducted, analyzing data from 36 patientswho underwent colonic polypectomy usingSSD at three hospitals in Thailand betweenMarch 2023 and September 2024.
Procedures were performed by threetrained endoscopists, each initially trainedon live porcine models under expertsupervision, followed by supervised clinicalprocedures before performingindependently.
Results
Of the 40 resected polyps,50% (20/40) were located in the sigmoid region, and 20%(8/40) were rectal polyps. 7(17.5%) were adenocarcinoma,16 (40%) high-grade adenomas, 14 (35%) low-grade adenomas,and 3 (7.5%) sessile serrated lesions
39 (97.5%) polyp has complete resection without perforation
2 (5.6%) care have a minor bleeding
| Pateint demographics | Number | 36 |
|---|---|---|
| Mean age (years) | 65.8 | |
| Gender (Male/Females) | 13 (36.1%)/ 23 (63.9%) | |
| Polyp Characteristics |
Total Polyps Removed |
40 |
| Mean Size (cm) |
2.7 (range: 1.3–6.0) |
|
| Large polyps (>3 cm) | 11/40 (27.5%) | |
| Procedural details |
Mean Procedure Time (min) |
116.8 (range: 25–360) |
| Mean Procedure Time (min),Large vs. Small Polyps(>3 cm vs. ≤3 cm) | 157.5 vs. 96.4 (p=0.185) | |
| Safety & Outcomes |
Complete Resection |
39 cases (97.5%) |
| Perforation | 0 case | |
| Bleeding | 2 cases, mild bleeding (5.6%) |
Conclusions
- High Efficacy & Safety: SSD achieved a97.5% complete resection rate with noperforations and only 5.6% (2 cases) of mildbleeding, managed conservatively.
- Procedure Time: Mean procedureduration was 116.8 minutes, with nosignificant difference between larger (>3cm) and smaller (≤3 cm) polyps (157.5 minvs. 96.4 min, p = 0.185).
- Clinical Impact: SSD simplifies ESD,making it a promising tool for broaderclinical adoption, particularly for noviceendoscopists.