Endoscopic submucosal dissection for colonic lesions: why and how should we do it?

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Colorectal Oncology

Background:

• Colorectal cancer incidence is rising globally, particularly in Asia.
• Surgical resection poses risks for large non-polypoid colonic lesions and early-stage cancers.
• Endoscopic submucosal dissection (ESD) has emerged as a minimally invasive alternative.

Purpose of the Study:

• To review the development, efficacy, and safety of Endoscopic submucosal dissection (ESD).
• To advocate for standardized ESD programs in response to increasing colorectal cancer rates.
• To outline essential components for ESD program standardization.

Main Methods:

• Literature review on Endoscopic submucosal dissection (ESD) development and outcomes.
• Analysis of efficacy and safety data for ESD in colorectal conditions.
• Discussion of factors contributing to successful ESD implementation.

Main Results:

• Endoscopic submucosal dissection (ESD) is demonstrated as a safe and effective endoscopic treatment.
• ESD provides a viable alternative to surgical resection for specific colorectal lesions.
• The study highlights the growing importance of ESD in managing early colorectal neoplasia.

Conclusions:

• Standardization of Endoscopic submucosal dissection (ESD) programs is recommended.
• Key areas for standardization include patient selection, equipment, and operator training.
• Implementing standardized ESD protocols can improve patient outcomes and address rising colorectal cancer incidence.