Introduction of endoscopic submucosal dissection in the West

Friedel, David; Stavropoulos, Stavros N.

doi:10.4253/wjge.v10.i10.225

Cited by 29 publications

(23 citation statements)

References 72 publications

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“…These aspects could partially explain the observed heterogeneity in ESD technique, exemplified by the usage of a wide range of knives and solutions for submucosal injection. This finding probably translates the personal preferences of ESD practitioners and is similar to what was reported in other Western studies (13)(14)(15)(16)(17) . Around 40% of the respondents reported perforation probably reflecting their initial learning curve and the limited training.…”

Section: Discussionsupporting

confidence: 89%

“…Many respondents had ESD experience in more than one organ. Such information resembles data reported in other Western surveys (6,(12)(13)(14)(15)(16) . Those findings could be partially explained by the absence of an organized screening program for superficial neoplasia detection, resulting in a low number of cases from different organs.…”

Section: Discussionsupporting

confidence: 87%

“…The first reports of ESD from Europe also showed disappointing outcomes, according to nationwide surveys conducted to assess the profile of the endoscopist performing ESD and to monitor clinical outcomes (13)(14)(15) . In France, the reported adverse events rate was 29.2% in the early days of ESD practice (15) .…”

Section: Discussionmentioning

confidence: 99%

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Is Endoscopic Submucosal Dissection Still Limited to Few Tertiary Centers in the West? Results From a National Survey in Brazil

Arantes

Sanna

Alves

et al. 2020

Arq. Gastroenterol.

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BACKGROUND: Endoscopic submucosal dissection (ESD) enables en bloc excision of superficial neoplasms. Although ESD is widely practiced in Eastern countries like Japan, South Korea and China, its use in the West is supposed to be still limited to few tertiary centers. OBJECTIVE: This study aimed to investigate the clinical practice of ESD in Brazil by means of an electronic questionnaire elaborated by the Brazilian Society of Digestive Endoscopy (SOBED). METHODS: In October 2019, 3512 endoscopist members of SOBED were invited to respond to an electronic survey containing 40 questions divided into four topics: operator profile; clinical experience with ESD; adverse events and training. Informed consent was requested to all participants. The investigators reviewed all responses and considered valid if more than 50% of the questions were answered and additional information, when requested, was provided. RESULTS: A total of 155 (4.4%) qualified responses entered the study. ESD has been practiced in 22 of 26 Federation States and majority of respondents (32.2%) have 10 to 20 years of practice. ESD has been performed more frequently in private hospitals (101 individuals, 66.9%) and private ambulatory centers (41 individuals, 27.1%). ESD was performed mainly in the stomach (72%), followed by the rectum (57%) and 80% of the individuals reported less than 25 operations. Twenty-four (15.4 %) individuals reported perforation and 4 (2.5%) of them reported postoperative deaths. Approximately a quarter of responders denied hands-on training in models or visit to training centers. CONCLUSION: ESD appears to be practiced throughout the country, not only in tertiary or academic institutions and mainly in private practice. Most operators received limited training and still are at the beginning of their learning curve. The reported adverse events and mortality rates appear to be higher than Eastern reports.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 87%

See 1 more Smart Citation

Is Endoscopic Submucosal Dissection Still Limited to Few Tertiary Centers in the West? Results From a National Survey in Brazil

Arantes

Sanna

Alves

et al. 2020

Arq. Gastroenterol.

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“…Many of these complications are associated with surgeon-dependent factors (23,24). Depending on the experience, hemorrhage and perforations can be managed with clips and coagulation (25). In our study, hemorrhage occurred in only one patient who underwent ESD, and it was stopped using both coagulation and clips, and no patient had perforation.…”

Section: Discussionmentioning

confidence: 60%

Endoscopic Approach to Esophageal Leiomyomas: Single Center Results

Çakar¹,

İdiz²,

Çolak³

et al. 2020

Istanbul Med J

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Benign lesions of the esophagus are rare lesions and constitute less than 1% of all esophageal lesions, and 2/3 of these lesions are leiomyomas, and the rest are polyps and cysts (1). Although esophageal leiomyomas are seen at any age from the age of 20 to the age of 80, they are most frequently observed between the ages of 40-50 and show similar morphological features as the leiomyomas observed in other organs. Leiomyomas generally originate from muscularis propria and can grow up to 30 cm intraluminally and extraluminally (2-4).

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“…These include lower availability of mentors for a technically challenging procedure, high complication rates, and a significantly lower prevalence of early gastric cancer. 5 Hybrid ESD involves ESD combined with the snaring of EMR, simplifying the most challenging ESD step: submucosal dissection. This is associated with shorter procedure times and lower complication rates, but with lower en-bloc resection rates.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic submucosal dissection: an update on tools and accessories

Harlow

Sivananthan

Ayaru

et al. 2020

Clin Med Insights Gastroenterol

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Endoscopic submucosal dissection (ESD) is a minimally invasive therapeutic procedure to remove larger polyps or early non-metastatic lesions. It has long been used in Asia, but is now fast growing in popularity in the West. There are multiple challenges faced by ESD practitioners. While the practice of ESD in gastric lesions is relatively well established, the oesophagus with its narrow lumen and challenging workspace, and the colon with its tortuous course and folds are more challenging frontiers. The nature of performing a procedure endoscopically means that conventional methods offer no mechanism for providing counter-traction while performing dissection, impeding visibility and increasing the rate of complications. There are a multitude of tools available to those performing ESD for the different stages of the procedure. This article reviews the accessories currently used in regular ESD practice including the knives used to cut and dissect lesions, the cap and hood devices used to improve visibility and safety, injection fluids to lift the submucosal plane, haemostatic devices, generators, and finally, emerging traction apparatus. There is some evidence behind the use of these tools, however, ESD remains the domain of a small number of practitioners and the practice relies heavily on expert experience. Evolution of the ESD toolbox will make the procedure more accessible to more endoscopists, which in turn will drive the development of a more substantial evidence base to evaluate efficacy and safety of the multitude of tools.

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Introduction of endoscopic submucosal dissection in the West

Cited by 29 publications

References 72 publications

Is Endoscopic Submucosal Dissection Still Limited to Few Tertiary Centers in the West? Results From a National Survey in Brazil

Is Endoscopic Submucosal Dissection Still Limited to Few Tertiary Centers in the West? Results From a National Survey in Brazil

Endoscopic Approach to Esophageal Leiomyomas: Single Center Results

Endoscopic submucosal dissection: an update on tools and accessories

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