Endoscopic submucosal dissection,
does it really help with 12-month recurrence in early rectal neoplasms larger than 20 mm?
research showsGrade C. The comparator was transanal minimally invasive surgery, not endoscopic mucosal resection. Recurrence was zero with ESD and two with TAMIS; ITT risk difference was -6.7 points (90% CI -14.2 to 0.8), meeting the 10-point margin.
ads claimVerdict 2703 is B with 76 points for laparoscopic liver resection and verdict 2793 is B with 76 points for laparoscopic gastrectomy; different organs and questions mean they are not replication.
Useful facts when choosing a product
- This is newly published 2026 evidence.
- Spanish endoscopy-society support was reported.
What the research actually shows
The primary endpoint was '12-month recurrence (noninferiority margin, 10%).' ① Defect: noninferiority design. ② It is the listed noninferiority item. ③ A 10-point margin was used. ④ A stricter margin or superiority design was feasible, so it was counted. ① Defect: fewer than 200 participants. ② It is the listed small-study item. ③ Seventy-three were randomized and 66 (90.4%) completed follow-up. ④ The condition does not make a larger multicenter trial impossible, so it was counted. ① Defect: active comparator only. ② It is the listed active-only item. ③ Only ESD and TAMIS were compared. ④ A sham procedure was ethically and practically impossible, so it was not counted. Missing follow-up was 7/73, 9.6%, below 15%.
Why this is classified as C (56)
A recent publicly supported trial met recurrence noninferiority, but one small 73-person noninferiority trial gives C, 56.
Counterpoint. Stay was 1 versus 2 days and estimated cost about EUR6,167 versus EUR11,289 favoring ESD.
Rejudgment record. Source checked — One 73-person procedural noninferiority RCT with 12-month recurrence
| Endpoint | H | Hard endpoint - actual events such as death |
| Replication | R1 | Single confirmatory trial |
| Independence | I2 | Decisive evidence is publicly or non-profit funded |
| Effect size | E+ | Meets the clinically important threshold |
The scoring table and the verdict agree (C).
Sub-claim grades by effect
This ingredient is marketed for several effects. A single overall grade blends strong and weak claims together, so each effect is graded separately here. The overall grade reflects the strongest disconfirming or core claim.
| Effect (sub-claim) | Grade | Basis |
|---|---|---|
| Noninferior 12-month local recurrence | C | Evidence comes from one small trial. |
Cross-check — AI research and Codex final gate
Evidence Table
| Study | Design | Sample | Funding | Endpoint | Result | Weight |
|---|---|---|---|---|---|---|
| DSETAMIS-2018 | Three-center open-label randomized noninferiority trial | 66 | Nonprofit support including the Spanish Society of Gastrointestinal Endoscopy | 12-month local recurrence | 0 with ESD vs 2 with TAMIS; ITT risk difference -6.7 points (90% CI -14.2 to 0.8) | Single current trial |
Receipt — 1 References
All 1 cited sources were verified for existence at the original page (as of 2026-08-26).
Final verification and publication gate: Codex · Verification cutoff: 2026-08-26 · Corrections: none
Cite this verdict
[Chamgap] Benefit of Endoscopic Submucosal Dissection for 12-Month Outcomes in Early Rectal Neoplasms Larger Than 20 mm — Evidence Grade C·56. 1 cited sources checked. Source: https://chamgap.com/en/verdicts/gut/esd-early-rectal-neoplasms-over-20mm-12-month-recurrence/ · CC BY 4.0CC BY 4.0 — free to use with attribution; do not distort grades, numbers, or verdict meaning.
What this document does and does not do
Chamgap is an information source. It reports what research has and has not confirmed; it does not tell readers what to take or buy. That decision belongs to readers and, when needed, medical or legal professionals. This verdict reflects literature available up to the search date and may change as new research appears. Nothing here is medical advice.