Endoscopic Submucosal Dissection in Early-Stage Colorectal Cancer

An estimated one in 12 people develop gastrointestinal cancer over their lifetime. Treatments on this front have advanced considerably in recent years.

Endoscopic submucosal dissection is a minimally invasive procedure used to
remove precancerous lesions and early-stage cancerous lesions from the gastrointestinal tract.

"In the past, any cancer or any abnormal lesion in the colon or rectum was treated by taking that segment out of the body or removing that segment by surgery and completely eliminating that," says Emre Gorgun, MD, Vice Chair at the Department of Colorectal Surgery and Co-Director of the Endoluminal Surgery Center at Cleveland Clinic. "That's a lot of undertake for a human being. Nowadays, there are more of these innovative endoscopic less invasive methods."

In a recent episode of Cleveland Clinic’s Cancer Advances podcast, Dr. Gorgun discusses:

- Traditional surgical approaches
- The emergence of minimally invasive procedures
- The safety and efficacy of enndoscopic submucosal dissection for early-stage colorectal cancer
- Impacts of new surgical approaches on patients' quality of life

Click the podcast player above to listen to the episode now, or read on for a short edited excerpt. Check out more Cancer Advances episodes at clevelandclinic.org/podcasts/cancer-advances or wherever you get your podcasts.

Excerpt from the podcast:

Dale Shepard, MD, PhD: I think when people think about colorectal cancers and colon surgeries, they oftentimes think of those stomas and ostomy bags and things. How has the world shifted away from that? If you think about a few years ago versus now, how much of a reality is that now?

Emre Gorgun, MD: There's a huge improvement and a large number of changes. First of all, of course, stoma bags are not the end of the world.
They sometimes are life-saving and provide a great quality of life for our patients, but compared to the last decade or so, we have gone and made a lot of progress.

Less and less we use stomas, but a lot of new adjuvant treatments, chemotherapy, radiation therapies as well as endoluminal approaches and endoscopic approaches. So we try to do more and more aggressive in organ preservation not to necessarily remove that organ segment, but endoscopically or medically with chemotherapy and immunotherapy.

Another aspect, for example, in rectal cancer treatment, we do a large amount of sphincter preserving operations to preserve those muscles. So, that's really a lot of improvement on the medicine side and on the surgical side that we provide.