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World J Gastroenterol. Jun 7, 2014; 20(21): 6425-6432
Published online Jun 7, 2014. doi: 10.3748/wjg.v20.i21.6425
Endoscopic therapy for early gastric cancer: Standard techniques and recent advances in ESD
Keiichiro Kume
Keiichiro Kume, Third Department of Internal Medicine, University of Occupational and Environmental Health, Japan, School of Medicine, Kitakyusyu 807-8555, Japan
Author contributions: Kume K wrote this review.
Correspondence to: Keiichiro Kume, MD, PhD, Third Department of Internal Medicine, University of Occupational and Environmental Health, Japan, School of Medicine, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyusyu 807-8555, Japan. k-kume@med.uoeh-u.ac.jp
Telephone: +81-93-6031611 Fax: +81-93-6920107
Received: November 22, 2013
Revised: January 12, 2014
Accepted: February 17, 2014
Published online: June 7, 2014
Processing time: 196 Days and 2.1 Hours
Abstract

The technique of endoscopic submucosal dissection (ESD) is now a well-known endoscopic therapy for early gastric cancer. ESD was introduced to resect large specimens of early gastric cancer in a single piece. ESD can provide precision of histologic diagnosis and can also reduce the recurrence rate. However, the drawback of ESD is its technical difficulty, and, consequently, it is associated with a high rate of complications, the need for advanced endoscopic techniques, and a lengthy procedure time. Various advances in the devices and techniques used for ESD have contributed to overcoming these drawbacks.

Keywords: Endoscopic submucosal dissection; Early gastric cancer; Standard techniques; Recent advances; Complications; Indications

Core tip: Endoscopic submucosal dissection (ESD) enables en bloc resection of early gastric cancer, facilitating detailed histopathological evaluation. ESD needs to be performed by highly skilled endoscopists in order to prevent procedural complications. To overcome this disadvantage of ESD, there have been various advances in the knives and other accessories used for this procedure.