Objective      To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) for the treatment of colon large laterally spreading tumor (LST).       Methods      ESD was applied to treat 28 cases of colon LST with diameter larger than 5 cm (large LST). The therapeutic effect

pathologic characteristics and complications were retrospectively evaluated.        Results      The 28 cases of colon large LSTs were granular type (LST-G)

including 7 cases of homogeneous granular type

and 21 cases of nodular mixed tumor. The tumor diameter was about 6.88±2.10 cm

and the largest was 12 cm. The operation time was in the range of 25 to 380 min

and the medium time was 72.5 min. The complete resection rate was 92.2% (26/28)

and the curative resection rate was 89.3% (25/28). The perforation rate

delayed bleeding rate and postoperative stenosis rate were 10.7% (3/28)

10.7% (3/28) and 10.7% (3/28)

respectively. There was no recurrence after postoperative follow-up for 3 to 29 months.       Conclusion      ESD is effective and safe for the treatment of colon large LST without invading the submucosa. The surgery has high risk

so it is recommended to be done by experienced doctors with proper equipment.