ASGE DDW Videos from Around the World | 2026-COMPLETE ENDOSCOPIC MANAGEMENT OF T3 RECTAL CANCER AFTER NEOADJUVANT THERAPY USING ENDOSCOPIC INTERMUSCULAR DISSECTION

COMPLETE ENDOSCOPIC MANAGEMENT OF T3 RECTAL CANCER AFTER NEOADJUVANT THERAPY USING ENDOSCOPIC INTERMUSCULAR DISSECTION

Video Transcription

Video Summary

This case describes a 48-year-old woman with cT3N2aM0 rectal cancer who had a near-complete response after neoadjuvant chemoradiation and CAPOX. Because she wished to avoid proctectomy, the team performed endoscopic intermuscular dissection (EID) to remove the fibrotic residual scar. By dissecting between the circular and longitudinal muscle layers, the lesion was resected en bloc without full-thickness perforation. Pathology showed no residual adenocarcinoma, only low-grade dysplasia and fibrosis, with negative margins. She remained recurrence-free for 24 months. EID may be a safe, organ-preserving option for selected rectal cancer patients after major treatment response.

Asset Subtitle

Submitted by Sushrut Ingawale

Keywords

rectal cancer

endoscopic intermuscular dissection

neoadjuvant chemoradiation

organ-preserving treatment

fibrotic residual scar