Progress of endoscopic resection for neoplasm of upper gastrointestinal tract

The biggest topic of therapeutic endoscopy in recent years is a development of new therapeutic strategy for neoplasm of the gastrointestinal tract using endoscopic submucosal dissection (ESD) technique. Ever since the emergence of ESD, indication criteria for endoscopic resection of neoplasm were extended through expansion of both theoretical and technical conditions and use of ESD is rapidly becoming widespread. ESD could not only avert the surgical risk without the lack of equal curability of surgical operation, but also bring large benefit for the patients QOL. But the technical difficulty is much higher and requires much higher skills. So ESD should be introduced after acquiring through knowledge and skill of usual ESD. And we have to continue making effort to realize safer, more reliable treatment.