UT Health San Antonio’s Advanced Interventional Gastroenterology Program is now offering an advanced, minimally invasive procedure that allows physicians to remove large, early-stage colorectal lesions without the need for traditional surgery. The technique, known as endoscopic submucosal dissection (ESD), is an innovative advancement for the South Texas region and represents a major step forward in gastrointestinal care, offering patients curative results with faster recovery.
“This is an innovative procedure that can completely remove large lesions through a scope, instead of sending patients to surgery,” said Matheus Franco, MD, PhD, gastroenterologist and director of endoscopy at the UT Health San Antonio Multispecialty and Research Hospital. “We performed a fully curative resection for our very first patient to have this procedure. That patient spent just one night in the hospital for observation and was back home the next day.”
A less invasive option for a common condition
According to the American Cancer Society, colorectal cancer is the third most common cancer diagnosis and the third leading cause of cancer death in both men and women in the U.S. and Texas. In this region, colorectal cancer mortality is 14 per 100,000, underscoring the need for earlier detection and advanced treatment options.
Endoscopic submucosal dissection allows physicians to remove polyps through a flexible endoscope inserted into the colon. Specialized instruments are used to carefully lift and dissect the lesion from surrounding tissue, achieving complete removal without external incisions.
ESD is particularly valuable for treating large benign polyps and early-stage cancers. In many cases, it allows patients to avoid the risks of major surgery and preserve normal bowel function. “If the cancer is detected early, we can remove it completely with ESD and achieve a curative outcome,” Franco said. “For more advanced cases, surgery or chemotherapy may still be necessary.”
Screening and prevention are key
Early detection of colorectal cancer through routine screening is critical. Most early-stage lesions cause no symptoms, but patients should be aware of warning signs such as rectal bleeding, abdominal pain or changes in bowel habits.
“Bleeding in the stool, abdominal discomfort or noticing that stools have become thinner are red flags that shouldn’t be ignored,” Franco said. “These changes should prompt a visit to a doctor and, if appropriate, a colonoscopy.”
While most patients are diagnosed at age 55 or older, screening is recommended starting at age 45. Franco also emphasized the role of lifestyle in reducing risk. Diets high in fiber and vegetables, regular physical activity, and avoiding smoking and excessive alcohol can all help lower risk. “Processed foods, high-fat diets and a sedentary lifestyle increase the likelihood of developing colorectal disease,” he said. “Living a healthy lifestyle is one of the best ways to protect against colorectal cancer.”
Advanced expertise, close to home
Though the need is high, ESD is offered at only a limited number of centers in the United States. UT Health San Antonio is one of the first in the region with the specialized training and technology required for the procedure. Previously, many patients had to travel to Houston or Dallas for complex procedures like ESD.
“This is still a new technique, so very few centers can provide it,” Franco said. “But it is a great option for many patients, and UT Health San Antonio is committed to bringing this innovation to our community.”
Endoscopic submucosal dissection requires a physician referral. To learn more or find out if you’re eligible, call 210-450-9880 to schedule an appointment with our Advanced Interventional Gastroenterology team.