ESD – Εndoscopic Submucosal Dissection

What is ESD? (Endoscopic Submucosal Dissection)

It is the latest development in invasive endoscopy for treating early malignant lesions of the digestive tract (esophagus, stomach, colon). By means of microsurgical instruments that are inserted into an endoscope through the mouth or anus, the gastroenterologist is able to remove in one specimen (en block resection), small or larger tumors. ESD was established in Japan 15 years ago, with spectacular results, and is now considered internationally as the treatment of choice for early cancerous lesions of the digestive tract. Technically-wise it is a very demanding procedure that needs appropriate training and specific equipment. The main advantage of ESD, is that it spares the need for more invasive procedures, such as esophagectomy, gastrectomy or colectomy), by means of an incisionless technique.

What are the indications for ESD?

High grade dysplasia or superficial malignancy of the esophagus, stomach or colon without suspicion of deep submucosal invasion. In addition, novel ESD-derived techniques have been emerged for the treatment of benign conditions such as Achalasia (POEM), Zenker’s Diverticulum (Z-POEM) and Gastroparesis (G-POEM)

What are the benefits for the patient?

Patients with tumors of the esophagus, stomach, colon may avoid a surgical procedure which bares a significant rate of morbidity such as esophagectomy, gastrectomy, or colectomy, respectively. The hospitalization time is shorter, the functional consequences are negligible, and the total cost of treatment – hospitalization is lower.

What is the duration of an ESD?

The duration of the procedure depends on the technical difficulties and the experience of the doctor. ESD of a small lesion lasts 60 to 90 minutes, while more complex interventions can take up to 4 hours.

What is the duration of hospitalization?

ESD is usually performed with general anesthesia with the exception of rectal lesions where deep sedation is sufficient. The patient is usually hospitalized for 24 to 48 hours.

Stethascope - ESD - Εndoscopic Submucosal Dissection
PateintCare - ESD - Εndoscopic Submucosal Dissection
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