The Healing Process of Artificial Colorectal Ulcers after Endoscopic Submucosal Dissection

Abstract

AIM: Endoscopic submucosal dissection applied to endoscopic resection of larger lesions in the gastrointestinal tract may result in the creation of large artificial ulcers. The healing process of colorectal ulcers post-endoscopic submucosal dissection is still unclear. The purpose of this study was to evaluate the healing process of colorectal ulcers post-endoscopic submucosal dissection, using endoscopy and endoscopic ultrasonography.

METHODS: Twenty patients who underwent colorectal endoscopic submucosal dissection between July 2009 and January 2011 were included in this study. Endoscopy and endoscopic ultrasonography were performed to evaluate healing of the artificial colorectal ulcers 4 weeks post-endoscopic submucosal dissection. Ten of the patients with ulcers that had not healed within 4 weeks were examined again after 8 weeks.

RESULTS: Endoscopic observation parameters included ulcer size, location and healing stage.All post-endoscopic submucosal dissection ulcers healed within 8 weeks. In ulcers healed within 4 weeks (early), the mean size of resected specimens was 31.0 mm (longaxis). In ulcers requiring more than 4 weeks to heal (late), the mean size of specimens was 47.8 mm, which was significantly different to the early healing group (p<0.05). The locations of ulcers were not significantly different between the two groups. The study was limited by the small number of cases from a single center.

CONCLUSIONS: Colorectal ulcers artificially created by endoscopic submucosal dissection heal within 8 weeks, regardless of size and location. The larger specimen sizes take longer to heal.