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Yoshizaki et al. Mini-invasive Surg 2022;6:17 https://dx.doi.org/10.20517/2574-1225.2021.116 Page 7 of 9

Figure 5. Lesions involving the ileocecal valve: (A, B) a lesion located on the ileocecal valve extended to the terminal ileum; (C) incision
of the mucosa and vascular network on the ileal side; (D) fat-rich submucosa; and (E, F) the ulcer bed and specimen after ESD. ESD:
Endoscopic submucosal dissection.

CONCLUSION
The indications for ESD of colorectal lesions that were previously difficult to treat endoscopically, such as
large lesions, difficult cases, and difficult location, have been expanding. Conversely, not all lesions must be
resected by ESD, and many lesions can be treated by EMR or piecemeal resection. Laparoscopic surgery for
colonic lesions is less invasive and has a better functional outcome. There is great value in endoscopic
treatment for rectal lesions. It is hoped that further knowledge in this field will be accumulated and will be
of benefit to patients.

DECLARATIONS
Author’s contributions
Made substantial contributions to conception and design of the study and performed data analysis and
interpretation: Yoshizaki T, Toyonaga T, Ikezawa N, Nakano Y, Tanaka S, Ishida T, Rahni DO, Jacob H,
Rahmi G, Kodama Y

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
All authors declared that there are no conflicts of interest.