Endoscopic Submucosal Dissection vs Local Laparoscopic Surgical Resection (TAMIS/TEO) in Early Rectal Neoplasias

Inclusion Criteria: * Patients older than 18 y/o * Non-pedunculated rectal lesions (sessile 0-Is or flat 0-II) greater than 20 mm in diameter. * The edges of the lesion should be more than 3 cm from the external anal margin and up to 14 cm from it. * Circumferential involvement \<50% Exclusion Criteria: * Patients who refuse to participate. * Diagnosis of inflammatory bowel disease with rectal involvement. * Pregnant. * Anorectal fibrosis due to previous anorectal surgery. * Lateral Spreading Lesions (LST classification) Granular Homogeneous type * Lesions greater than 50 mm when there is suspicion of advanced histology (Kudo Vi superficial pattern). * Rectal lesions of any size with high suspicion of deep submucosal invasion or locoregional lymph node involvement, either in the diagnostic colonoscopy (Kudo Vn pit pattern, NICE 3 pattern, Sano IIIB pattern) or by complementary imaging tests (rectal EUS/Pelvic MRI) * Existence of synchronous colorectal lesions that require other surgical treatment in any case.