Colorectal endoscopic submucosal dissection

Is it suitable in western countries?

Toshio Uraoka, Adolfo Parra-Blanco, Naohisa Yahagi

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

Endoscopic submucosal dissection (ESD) represents a significant advance in therapeutic endoscopy with the major advantage being the ability to achieve a higher en bloc resection rate for early stage lesions. Western endoscopists infrequently perform colorectal ESD (CR-ESD) because of the greater technical difficulty involved, longer procedure times, and increased risk of perforation. Specialized training and sufficient clinical experience are necessary to successfully perform ESDs, but a systematic education and training program has still not been established in Japan or elsewhere in the world. Experts generally acknowledge that the stomach is the first organ in which endoscopists should begin performing ESDs. The incidence and detection rates for early stage gastric cancer are significantly higher in Japan than in western countries, so Japanese endoscopists have a greater opportunity to perform gastric ESDs than their western counterparts. It is logical to ask, therefore, whether CR-ESD can be effectively applied in western countries. Based on a review of the relevant literature and our practical perspective, we have focused on the progress made in performing CR-ESD, its indications, training methods, and learning curve. Use of animal gastric and colon models is strongly recommended along with accumulating the necessary experience from the rectum to the colon on a step-by-step basis. It is reasonable to assume that an increasing number of CR-ESDs will be performed by western endoscopists in the foreseeable future given the continuing development of new techniques, and the refinement of instruments and other technologically advanced devices together with the creation of even more effective submucosal injection agents.

Original languageEnglish
Pages (from-to)406-414
Number of pages9
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume28
Issue number3
DOIs
Publication statusPublished - 2013

Fingerprint

Stomach
Japan
Colon
Education
Aptitude
Learning Curve
Rectum
Endoscopy
Stomach Neoplasms
Equipment and Supplies
Injections
Incidence
Endoscopic Mucosal Resection
Therapeutics

Keywords

  • Colonoscopy
  • Colorectal cancer
  • Colorectum
  • Endoscopic submucosal dissection

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

Colorectal endoscopic submucosal dissection : Is it suitable in western countries? / Uraoka, Toshio; Parra-Blanco, Adolfo; Yahagi, Naohisa.

In: Journal of Gastroenterology and Hepatology (Australia), Vol. 28, No. 3, 2013, p. 406-414.

Research output: Contribution to journalArticle

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