Endoscopic resection of colitis-associated neoplasia: A scoping review

Table 6 Studies evaluating impact of submucosal fibrosis in endoscopic submucosal dissection on ulcerative colitis associated neopalsia

Parameter	Félix et al[36], 2023	Nishio et al[37], 2024	Ozeki et al[1], 2021	Hayashi et al[38], 2014
Setting	Western center, rectal ESD	UC patients, colonic ESD	Colorectal tumors with fibrosis	Japanese academic center
Sample size	195 lesions	55 lesions	133 lesions	267 lesions
Severe fibrosis (%)	23.1%	49%	72.2%	F2 = 34%
Impact on R0/curative (%)	R0: 61.4%, curative: 54.5%	R0: 93%, Curative: 93%	Shorter procedure time with WP-ESD	En bloc: 95.9%, incomplete: 4.1%
Key predictors	UC, prior EMR, deep SM invasion	UC duration ≥ 10 years, scarring mucosa	Prior treatment, UC	Severe fibrosis, poor operability, SM deep invasion
Comments	Lower resection speed, more hybrid ESD needed	Higher perforation in F2 fibrosis (30%)	WP-ESD reduced time; safety comparable to C-ESD	Severe fibrosis and poor operability independently predicted perforation

UC: Ulcerative colitis; ESD: Endoscopic submucosal dissection; EMR: Endoscopic mucosal resection; R0: Histologically clear margins; C-ESD: Conventional endoscopic submucosal dissection; WP-ESD: Water pressure-assisted endoscopic submucosal dissection; SM: Submucosal.