Worldwide experiences of endoscopic submucosal dissection: not just Eastern acrobatics

The high incidence of gastric cancer has led to the initiation of cancer screening programs. As a result, the number of early gastric cancer cases has increased and consequentially, the cancer mortality rate has decreased. Moreover, the development of minimally invasive endoscopic treatment has been introduced for these early lesions. Endoscopic submucosal dissection (ESD) is now recognized as one of the preferred treatment modalities for premalignant gastrointestinal epithelial lesions and early gastric cancer without lymph node metastasis. We review the results of ESD including experiences in Japan and Korea, as well as western countries.