Abstract:Objective To investigate the application of endoscopic piecemeal mucosal resection (EPMR), endoscopic submucosal dissection (ESD), optimized hybrid ESD (OHESD) and endoscopic mucosal resection (EMR) in the treatment of colorectal laterally spreading tumor (LST). Methods A total of 34 colorectal LST patients who were treated in Liuzhou Municipal Liutie Central Hospital from January 2014 to December 2015 were selected and divided into EPMR group (n=2), ESD group (n=20), OHESD group (n=6) and EMR group (n=6) according the operation method. The operation time, intraoperative bleeding and perforation situation were compared between four groups. Results The operation time in EMR group, EPMR group, OHESD group and ESD group were (36.0±1.7) min, (38.0±6.9) min, (71.0±4.2) min, and (120.0±35.0) min respectively. The operation time in ESD group was longer than that in other three groups, and it in OHESD was longer than EPMR group and EMR group (all P<0.05). There were 6 cases of obvious intraoperative bleeding and 1 case of perforation in ESD group, and there were no intra- and post-operative bleeding in OHESD group, EPMR group and EMR group. Conclusion In the process of ESD operation, if the exfoliation is difficult, it is suggested not to force ESD and should switch to EMR in time.