ENDOSCOPIC SUBMUCOSAL DISSECTION IN THE COLORECTUM: PRESENT STATUS AND FUTURE PROSPECTS
Article first published online: 22 JUN 2009
© 2009 The Authors. © 2009 Japan Gastroenterological Endoscopy Society
Special Issue: Proceedings of the Endoscopy Forum, Japan 2007–2008
Volume 21, Issue Supplement s1, pages S13–S16, July 2009
How to Cite
Uraoka, T., Kawahara, Y., Kato, J., Saito, Y. and Yamamoto, K. (2009), ENDOSCOPIC SUBMUCOSAL DISSECTION IN THE COLORECTUM: PRESENT STATUS AND FUTURE PROSPECTS. Digestive Endoscopy, 21: S13–S16. doi: 10.1111/j.1443-1661.2009.00863.x
- Issue published online: 22 JUN 2009
- Article first published online: 22 JUN 2009
- Received 19 January 2009; accepted 16 February 2009.
- endoscopic submucosal dissection (ESD);
- thin endoscope assisted-ESD (TEA-ESD);
Endoscopic submucosal dissection (ESD) can successfully resect early stage gastrointestinal tumors, but colorectal ESDs are not widely performed, even by Japanese endoscopists, because of several negative factors. Besides being considerably more difficult in terms of technical demands, colorectal ESDs involve a longer procedure time and have a higher complication rate compared to gastric ESDs. In addition, most colorectal lesions are adenomas or intramucosal cancers that despite their large size that can be curatively treated by endoscopic mucosal resection including piecemeal resection.
There is, however, no doubt about ESD having a major therapeutic advantage in being able to achieve a higher en-bloc resection rate resulting in enhanced curability and more accurate histopathological assessment. Continued improvement in the technical skills of endoscopists, further refinement of such devices as electrical surgical knives and a special colonoscope as well as the development of more effective submucosal injection solutions and new traction systems are expected to facilitate easier, faster and safer colorectal ESD procedures in the relatively near future.