Abstract
Endoscopic submucosal dissection (ESD) has emerged as a minimally invasive technique for treating early colorectal cancer (CRC), offering the potential for en bloc resection and precise histopathological assessment. However, when ESD results in non-curative outcomes-characterized by factors such as positive margins, deep submucosal invasion, or lymphovascular invasion-salvage surgery becomes a critical consideration. This review synthesizes current evidence on the indications, timing, surgical approaches, outcomes, and future directions of salvage surgery following non-curative ESD in early CRC.