Open AccessTechnical issues and new devices of ESD of early gastric cancer
Author(s) -
Wan Sik Lee,
Jin Woong Cho,
Young Dae Kim,
Kyu Jong Kim,
Byung Ik Jang
Publication year - 2011
Publication title -
world journal of gastroenterology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.427
H-Index - 155
eISSN - 2219-2840
pISSN - 1007-9327
DOI - 10.3748/wjg.v17.i31.3585
Subject(s) - endoscopic submucosal dissection , medicine , cancer , lymph node metastasis , endoscopic mucosal resection , dissection (medical) , endoscopy , muscular layer , metastasis , computer science , surgery
Endoscopic submucosal dissection (ESD) is a highly refined technique compared to conventional endoscopic mucosal resection. It enables complete resection of early gastric cancer (EGC) which has no possibility of lymph node metastasis. Indication for ESD of EGC generally entails early gastric cancer confined to the mucosa with well differentiated histology, though there are clinically suitable expanded criteria. As ESD requires specific skill and expertise, endoscopists need to be familiarized with basic methods and the use of special devices. The essence of the technique is to dissect the submucosal layer with direct vision and maintain the cutting plane above the underlying proper muscle layer. Although there are some differences in the detailed technical aspect, the cardinal method of ESD is now well established and standardized. Furthermore, research and development of new ESD devices that render more efficient, safe ESD are still in progress to improve the overall result of ESD on early gastric cancer.