Editorial
Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. May 21, 2008; 14(19): 2962-2967
Published online May 21, 2008. doi: 10.3748/wjg.14.2962
Endoscopic submucosal dissection for gastrointestinal neoplasms
Naomi Kakushima, Mitsuhiro Fujishiro
Naomi Kakushima, Mitsuhiro Fujishiro, Department of Gastroenterology, The University of Tokyo, Graduate School of Medicine, Tokyo 113-8655, Japan
Author contributions: Kakushima N and Fujishiro M contributed equally to this work; Kakushima N and Fujishiro M perfomed research, and wrote the paper.
Correspondence to: Naomi Kakushima, MD, PhD, Department of Gastroenterology, The University of Tokyo, Graduate School of Medicine, 7-3-1 Hongo, Bunkyoku, Tokyo 113-8655, Japan. kakushin-tky@umin.ac.jp
Telephone: +81-3-38155411
Fax: +81-3-58008806
Received: February 22, 2008
Revised: March 26, 2008
Published online: May 21, 2008
Abstract

Endoscopic submucosal dissection (ESD) is an advanced technique of therapeutic endoscopy for superficial gastrointestinal neoplasms. Three steps characterize it: injecting fluid into the submucosa to elevate the lesion, cutting the surrounding mucosa of the lesion, and dissecting the submucosa beneath the lesion. The ESD technique has rapidly permeated in Japan for treatment of early gastric cancer, due to its excellent results of en-bloc resection compared to endoscopic mucosal resection (EMR). Although there is still room for improvement to lessen its technical difficulty, ESD has recently been applied to esophageal and colorectal neoplasms. Favorable short-term results have been reported, but the application of ESD should be well considered by three aspects: (1) the possibility of nodal metastases of the lesion, (2) technical difficulty such as location, ulceration and operator’s skill, and (3) organ characteristics.

Keywords: Endoscopic submucosal dissection; Gastric cancer; Esophageal cancer; Colorectal cancer; Endoscopic mucosal resection; Therapeutic endoscopy