Colorectal endoscopic submucosal dissection from a Western perspective: Today’s promises and future challenges

Table 1 Indications for colorectal endoscopic submucosal dissection (Japan Gastroenterological Endoscopy Society)

Lesions for which endoscopic en bloc resection is required

(1) Lesions for which en bloc resection with snare EMR is difficult to apply

LST-NG, particularly LST-NG pseudo-depressed type

Lesions showing a Vi-type pit pattern

Carcinoma with shallow T1 submucosal invasion

Large depressed-type tumors

Large protruded-type lesions suspected to be carcinoma. Including LST- G, nodular mixed type

(2) Mucosal tumors with submucosal fibrosis as a result of a previous biopsy or prolapse caused by intestinal peristalsis

(3) Sporadic localized tumors in conditions of chronic inflammation such as ulcerative colitis

(4) Local residual or recurrent early carcinomas after endoscopic resection

EMR: Endoscopic mucosal resection; LST-NG: Laterally spreading tumor non granular; LST-G: Laterally spreading tumor granular.