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Updated: Jun 7, 2026
Evaluation of the Effectiveness of Longitudinal Incision for Endoscopic Submucosal Excavation of Gastric Subepithelial Lesions
Published on: April 28, 2026
[Pathology of endoscopic submucosal dissection; how do we interpret?].
Kyoung Mee Kim1, Cheol Keun Park
1Department of Pathology, Samsung Seoul Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Endoscopic submucosal dissection (ESD) is key for early gastric cancer. Accurate pathology of ESD specimens is crucial for determining if further surgery is needed.
Area of Science:
- Gastroenterology
- Oncology
- Pathology
Context:
- Endoscopic submucosal dissection (ESD) is a primary treatment for early gastric carcinoma with low lymph node metastasis risk.
- Accurate pathological assessment of ESD specimens is vital for treatment decisions.
Purpose:
- To review the diagnostic approach for endoscopic submucosal dissection (ESD) specimens.
- To highlight potential pitfalls in the pathological diagnosis of ESD specimens.
Summary:
- ESD specimens require meticulous examination, including serial sectioning at 2 mm intervals.
- Submucosal invasion (>500 μm), lymphovascular invasion, or positive resection margins necessitate surgical intervention.
- Accurate pathological reporting ensures appropriate patient management post-ESD.
Impact:
- Improves patient selection for ESD versus surgery.
- Enhances diagnostic accuracy in early gastric cancer pathology.
- Contributes to standardized reporting of ESD specimens.
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