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Updated: Jul 14, 2026
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Evaluation of the Effectiveness of Longitudinal Incision for Endoscopic Submucosal Excavation of Gastric Subepithelial Lesions
Published on: April 28, 2026
Advantages of endoscopic submucosal dissection over conventional endoscopic mucosal resection
Takaya Shimura1, Makoto Sasaki, Hiromi Kataoka
1Department of Internal Medicine and Bioregulation, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
Journal of Gastroenterology and Hepatology
|June 15, 2007
Summary
Endoscopic submucosal dissection (ESD) offers higher en bloc resection rates for gastric neoplasms compared to conventional endoscopic mucosal resection (EMR). While ESD may take longer, it is a superior treatment option for intramucosal gastric neoplasms.
Area of Science:
- Gastroenterology
- Endoscopic Surgery
- Oncology
Background:
- Endoscopic mucosal resection (EMR) is standard for intramucosal gastric neoplasms.
- Conventional EMR using strip biopsy can lead to local recurrence due to piecemeal resection.
- Endoscopic submucosal dissection (ESD) utilizes new devices for improved resection.
Purpose of the Study:
- To evaluate the efficacy of endoscopic submucosal dissection (ESD).
- To compare ESD with conventional endoscopic mucosal resection (EMR).
- To identify problems and improvements associated with ESD.
Main Methods:
- Retrospective analysis of 48 lesions treated with EMR (Jan 1999-Oct 2002).
- Retrospective analysis of 59 lesions treated with ESD (Nov 2002-Jun 2005).
- ESD performed using insulation-tip diathermic knife, flex, and hook knives.
Main Results:
- ESD achieved significantly higher en bloc resection rates for lesions >= 11 mm.
- ESD treatment time was significantly longer than EMR.
- Various knives improved ESD en bloc resection rates and reduced intraoperative bleeding.
Conclusions:
- Endoscopic submucosal dissection (ESD) is superior to conventional endoscopic mucosal resection (EMR) for intramucosal gastric neoplasms.
- ESD may require longer procedure times but offers better resection outcomes.
- Ongoing device development enhances ESD safety and efficacy.
