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Review
, 6 (13), 261

Quality in Upper Gastrointestinal Endoscopic Submucosal Dissection

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Review

Quality in Upper Gastrointestinal Endoscopic Submucosal Dissection

Flaminia Purchiaroni et al. Ann Transl Med.

Abstract

Progress in the endoscopy technology field led to an increase in the diagnosis of early gastrointestinal (GI) superficial lesions and to an improvement of their treatment. Endoscopic submucosal dissection (ESD) has been developed in Japan with the aim of removing such lesions in one piece, in order to obtain a curative resection and to minimize the risk of local recurrence, and to preserve the native organ. ESD is widely used in Asia for the treatment of early upper and lower GI lesions and is currently gaining attention in Western countries too. However, ESD can be safely performed only by expert endoscopists and in specific clinical settings. Therefore, prior to decide whether ESD is feasible or not, the target lesion must be carefully assessed, in order to understand whether or not it is eligible for submucosal dissection. The aim of this paper is to review indications, limitations and technical aspects of upper GI ESD.

Keywords: ESD technique; Superficial upper gastrointestinal (GI) lesions; advanced imaging techniques; upper gastrointestinal (GI) endoscopic submucosal dissection (ESD) indications.

Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Flat SCC of the mid esophagus seen with Lugol staining and high-resolution endoscope. SCC, squamous cell carcinoma.
Figure 2
Figure 2
Margins delineation of EGC in the gastric fundus with NBI and magnification. EGC, early gastric cancer; NBI, narrow band imaging.
Figure 3
Figure 3
Marking of SCC in the mid esophagus. SCC, squamous cell carcinoma.
Figure 4
Figure 4
Circumferential mucosal incision of EGC in the gastric fundus. EGC, early gastric cancer.
Figure 5
Figure 5
Dissection of the submucosal plane of a gastric lesion and a coagulated vessel.

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