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World J Gastroenterol. Aug 21, 2011; 17(31): 3580-3584
Published online Aug 21, 2011. doi: 10.3748/wjg.v17.i31.3580
Do you have what it takes for challenging endoscopic submucosal dissection cases?
Kyoung-Oh Kim, Sung Jung Kim, Tae Hyeon Kim, Jong-Jae Park
Kyoung-Oh Kim, Sung Jung Kim, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Hallym University Medical Center, Seoul 150-030, South Korea
Tae Hyeon Kim, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Wonkwang University Hospital, Iksan 570-711, South Korea
Jong-Jae Park, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul 152-703, South Korea
Author contributions: Kim KO drafted the manuscript; Kim SJ and Kim TH gathered the data; Park JJ reviewed and edited the manuscript.
Correspondence to: Jong-Jae Park, MD, PhD, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, 97, Guro-dong, Guro-gu, Seoul 152-703, South Korea. gi7pjj@yahoo.co.kr
Telephone: +82-2-26261772 Fax: +82-2-26261038
Received: June 29, 2010
Revised: August 18, 2010
Accepted: August 25, 2010
Published online: August 21, 2011
Abstract

Endoscopic submucosal dissection (ESD) is a widely accepted treatment for early gastric cancer (EGC), especially in Korea and Japan. The criteria for the therapeutic use of ESD for EGC have been expanded recently. However, attention should be drawn to the technical feasibility of the ESD treatment which depends on a lesion’s location, size or fibrosis level, or operator’s experience. In the case of a lesion with a high level of difficulty, a more experienced operator is required. Thus, the treatment for a lesion with a high level of difficulty should be performed according to the degree of the operator’s experience. In this paper, the authors describe the ESD procedure for lesions with a high level of difficulty.

Keywords: Endoscopic submucosal dissection, Anatomical location, Technical feasibility