Objective  To investigate the clinical efficacy of endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) in the treatment of early colorectal cancer.

  Methods  The clinical data of patients with early colorectal cancer admitted to Fujian Provincial Hospital South Branch from May 2015 to December 2021 were retrospectively analyzed. Patients were assigned into the EMR and ESD groups according to different treatment methods. The operative time, en-bloc resection rate, complete resection rate, postoperative complication rate, and tumor recurrence rate were compared between the two groups.

  Results  A total of 167 patients (EMR: n=74 and ESD: n=93) were included in this study. The operative time of the ESD group was significantly longer than that of the EMR group (P < 0.05). When the lesion diameter was ≥20 mm, the en-bloc resection rate and complete resection rate were significantly higher in the ESD group than that in the EMR group (P < 0.05); however, when the lesion diameter was <20 mm, these rates were similar between the two groups (P > 0.05). In the EMR group, the en-bloc resection rate and complete resection rate were significantly lower for lesions with a diameter of≥ 20mm than those with a diameter of<20 mm (P < 0.05). The incidence of postoperative complications in the ESD group was higher than that in the EMR group (P < 0.05). The recurrence rate of the ESD group was lower than the EMR group; however, the difference was not statistically significant (P > 0.05).

  Conclusions  EMR is an effective treatment for lesions with a diameter of<20 mm. However, for lesions with a diameter ≥20 mm, ESD is preferable due to a higher complete resection rate and better clinical efficacy.