Colorectal endoscopic submucosal dissection: is it suitable in western countries?

Area of Science:

• Gastroenterology
• Therapeutic Endoscopy

Background:

• Endoscopic submucosal dissection (ESD) enables en bloc resection of early-stage lesions.
• Colorectal ESD (CR-ESD) is infrequently performed in Western countries due to technical difficulty and risks.

Purpose of the Study:

• To review the progress, indications, and training methods for colorectal ESD.
• To assess the feasibility of CR-ESD in Western countries.

Main Methods:

• Literature review and practical perspective.
• Focus on CR-ESD progress, indications, training, and learning curve.
• Recommendation for animal models and step-by-step experience accumulation.

Main Results:

• CR-ESD presents challenges for Western endoscopists compared to gastric ESD.
• A systematic training program for ESD is not yet established globally.
• Progress in CR-ESD is noted, with potential for increased future adoption.

Conclusions:

• Western endoscopists can potentially adopt CR-ESD with appropriate training.
• Animal models and progressive experience are crucial for learning CR-ESD.
• Advancements in techniques and devices may facilitate wider CR-ESD implementation.