Endoscopic submucosal dissection for gastric lesions: results of an European inquiry

Abstract

ESD in Europe seems to be performed at a few centers, with most endoscopists performing a low number of procedures, achieving a high rate of efficacy and a moderate rate of major complications. However, as a potential selection bias may have occurred, multicenter registries should be conducted to help address the problem of dissemination of this technique.

Endoscopic submucosal dissection of early gastric neoplasia with a water jet–assisted knife: a Western, single-center experience

“…The median total procedure time was 74 minutes, which is comparable to other published data with different devices. [2][3][4]23,24 Compared with Western studies using ESD, our procedure time was less than previously reported in these studies: the median procedure times were 85 minutes, 22 108 minutes, 11 and 161 minutes. 10 Compared with EMR, the ESD procedure time is significantly longer.…”

“…[3][4][5] A few small series also were reported from Western countries. [6][7][8][9][10][11] However, ESD has not yet been standardized, and it is technically difficult, time consuming, and potentially hazardous. 7 The aim of this study was to evaluate the efficacy and safety of ESD by use of a new water jet-assisted ESD (WESD) system in patients with early gastric neoplastic lesions.…”

Implementation of Endoscopic Submucosal Dissection for Gastric Lesions in Norway

“…In all, 11 of the 15 specimens were resected en bloc. Compared to other Western series (22), an en bloc resection rate of 73% in this study is acceptable and can be improved by always retrieving the specimen in a basket instead of with forceps, as we did in some cases. The reason why the R0 resection rate was higher than the en bloc rate is that two specimens were divided into two parts during retrieval.…”

Disección submucosa endoscópica, ¿solo para endoscopistas expertos?

“…Una encuesta europea reciente entre 58 endoscopistas europeos (de un total de 490) detectó una media de 4 disecciones submucosas gástricas por endoscopista y año (en el último año previo a la encuesta). De un total de 510 disecciones gástricas registradas, se alcanzó un 77% de resecciones completas con un 13% de complicaciones (hemorragia y perforación en el 8 y 5% de los casos, respectivamente) 152 . De este estudio, a pesar de la baja tasa de participación (12%) que puede introducir un sesgo de selección, se debe destacar que a pesar del escaso número de disecciones efectuadas por endoscopista y año, se consiguen unas elevadas tasas de resección completa con un razonable porcentaje de complicaciones mayores.…”