title: [Advances in surgical endoscopy: initial experience in endoscopic colonic submucosal dissection (ESD) in Costa Rica].
abstract: OBJECTIVE
  To report the first case in Costa Rica of a colon tumor removed by endoscopic submucosal dissection (ESD).
  
  
  METHODS
  We describe the case of a 70-year-old man with a multilobulated 25 millimeters tumor located in the cecum, near the ileocecal valve, detected during a routine colonoscopic check-up. The biopsy revealed a tubular adenoma with high grade dysplasia and the patient underwent an endoscopic submucosal en-bloc dissection of the lesion.
  
  
  RESULTS
  The procedure was successfully performed without complications such as bleeding or perforation. The operative time was 117 minutes. The histopathological analysis of the en-bloc specimen confirmed the diagnosis of high grade dysplasia with negative vertical and horizontal margins.
  
  
  CONCLUSIONS
  Colon ESD is an attractive and safe treatment option for the removal of premalignant lesions and some types of early colon cancer.
authors.affiliation: Divisiones de Cirugía y Endoscopia, Centro Digestivo Drs. Con-Mediplaza, San José, Costa Rica.
authors.forename: Sergio A
authors.initials: SA
authors.lastname: Con
authors.forename: Gustavo
authors.initials: G
authors.lastname: Kishimoto
authors.forename: Gil R
authors.initials: GR
authors.lastname: Con-Chin
authors.forename: Reinaldo
authors.initials: R
authors.lastname: Con-Wong
mesh_terms: D000236:Adenoma / Q000175:diagnosis / Q000601:surgery*; D000368:Aged; D002430:Cecal Neoplasms / Q000175:diagnosis / Q000601:surgery*; D003113:Colonoscopy / Q000379:methods*; D003364:Costa Rica; D004210:Dissection / Q000379:methods*; D006801:Humans; D008297:Male