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Multicenter Study
. 2025 May 8;19(5):jjaf057.
doi: 10.1093/ecco-jcc/jjaf057.

Endoscopic submucosal dissection for visible dysplasia in inflammatory bowel disease: a nationwide multicenter cohort from the GETAID and the SFED

Sophie Geyl  1 , Jérémie Jacques  1 , Alicia Anneraud  1 , Stanislas Chaussade  2 , Vered Abitbol  2 , Jean Baptiste Chevaux  3 , Laurent Peyrin-Biroulet  3 , Clara Yzet  4 , Mathieu Pioche  5 , Arthur Berger  6   7   8 , David Laharie  6   7   8 , Stéphane Koch  9 , Sarah Leblanc  10 , Mélanie Serrero  11 , Marc Barthet  11 , Jean Michel Gonzalez  11 , Timothée Wallenhorst  12 , Guillaume Bouguen  12 , Marine Camus  13 , Thibault Degand  14 , Maeva Charkaoui  14 , Gabriel Rahmi  15 , Guillaume Perrod  15 , Marion Simon  16 , Romain Gerard  17 , Carmen Stefanescu  18 , Alban Benezech  19 , Geoffroy Vanbiervliet  20 , Yann L E Baleur  21 , Bertrand Brieau  22 , Philippe Seksik  13 , Lucine Vuitton  9 , Marion Schaefer  3
Affiliations
Multicenter Study

Endoscopic submucosal dissection for visible dysplasia in inflammatory bowel disease: a nationwide multicenter cohort from the GETAID and the SFED

Sophie Geyl et al. J Crohns Colitis. .

Abstract

Background and aims: New techniques for endoscopic resection, including endoscopic submucosal dissection (ESD), have been developed to allow for en-bloc resection with very low recurrence rates and organ sparing in patients without inflammatory bowel disease (IBD). Data on ESD for the management of colorectal dysplasia in IBD patients are scarce. We aimed to evaluate the efficacy and safety of ESD for the treatment of IBD.

Methods: We conducted a retrospective multicenter cohort study that evaluated consecutive ESD procedures in IBD patients with visible dysplasia from 20 French centers with ESD experience. Between June 2008 and March 2022, all IBD patients included in the local ESD databases and who underwent ESD for visible dysplasia proven on biopsy were included. All patients were included from the date ESD was performed, and endoscopic follow-up and surgical data were collected.

Results: Among the 88 lesions resected in 82 patients (19 patients with Crohn's disease), 82% and 80% of patients had R0 and curative resection, respectively. Ten (12%) patients required surgery: 1 for complication, 3 for endoscopic failure, and 6 for noncurative resection. After a median follow-up of 20 (IQR 10.5-45) months, 4 patients experienced local recurrence, and 14 (17%) underwent surgery. Two patients died from cardiovascular issues during the follow-up. Factors associated with local recurrence were R1 resection, associated primary sclerosing cholangitis, a personal history of colorectal cancer, and active lesions at the ESD site.

Conclusions: Endoscopic submucosal dissection is feasible for IBD patients with visible colorectal dysplasia and has an acceptable safety profile. These findings should be evaluated further in control trials.

Keywords: dysplasia; endoscopic submucosal dissection; inflammatory bowel disease.

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