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Endoscopic submucosal dissection in the West: Current status and future directions
Michael X Ma1, Michael J Bourke1,2
1Department of Gastroenterology and Hepatology, Westmead Hospital, Sydney, Australia.
Summary
Endoscopic submucosal dissection (ESD) enables en bloc resection of large gastrointestinal lesions. This review examines ESD
Area of Science:
- Gastroenterology
- Endoscopic Surgery
- Oncology
Background:
- Endoscopic submucosal dissection (ESD) originated in Japan ~30 years ago and is prevalent in East Asia.
- ESD facilitates en bloc resection of large early neoplastic lesions in the gastrointestinal tract (GIT).
- It offers advantages over other endoscopic resection (ER) techniques for definitive staging and curative treatment of early GI cancers.
Purpose of the Study:
- To review the role and current status of ESD in Western endoscopic practice.
- To discuss the future potential and challenges of ESD adoption in Western countries.
Main Methods:
- This is a review article discussing the current literature and expert experience with ESD.
- It analyzes factors influencing ESD adoption in Western versus Eastern populations.
Main Results:
- ESD is widely practiced in East Asia with excellent outcomes reported from high-volume centers.
- Western endoscopists recognize ESD's benefits, but its adoption is limited.
- Key barriers include epidemiological differences in GIT neoplasia and training limitations.
Conclusions:
- ESD offers significant advantages for managing early gastrointestinal neoplasia.
- Addressing epidemiological and training disparities is crucial for expanding ESD in the West.
- Further research and training initiatives are needed to integrate ESD into Western endoscopic practice.
