title: Feasibility of endoscopic submucosal dissection for gastric and colorectal lesions: Initial experience from the Gastrocentro--UNICAMP.
abstract: OBJECTIVE
  Endoscopic submucosal dissection is a technique developed in Japan for en bloc resection with a lower rate of recurrence. It is considered technically difficult and performed only in specialized centers. This study sought to report the initial experience from the Gastrocentro--Campinas State University for the treatment of gastric and colorectal lesions by endoscopic submucosal dissection.
  
  
  METHODS
  The guidelines of the Japanese Association of Gastric Cancer were used as evaluative criteria. For colorectal lesions, the recommended standards proposed by Uraoka et al. and Saito et al. were employed. The practicability of the method, the development of complications and histological analysis of the specimens were evaluated.
  
  
  RESULTS
  Sixteen patients underwent endoscopic submucosal dissection from June 2010 to April 2011; nine patients were treated for gastric lesions, and seven were treated for colorectal lesions. The average diameter of the gastric lesions was 28.6 mm, and the duration of resection was 103 min without complications. All lesions presented lesion-free margins. Of the seven colorectal tumors, four were located in the rectum and three were located in the colon. The average size was 26 mm, and the average procedure time was 163 min. Two complications occurred during the rectal resection procedures: perforation, which was treated with an endoscopic clip, and controlled bleeding. One of the lesions presented a compromised lateral margin without relapse after 90 days. Depth margins were all free of lesions.
  
  
  CONCLUSIONS
  Endoscopic submucosal dissection at our institution achieved high success rates, with few complications in preliminary procedures. The procedure also made appropriate lesion staging possible.
authors.affiliation: Gastrocentro, Digestive Endoscopy Unit, Campinas State University, Campinas, SP, Brazil. olympiomeirelles@gcunicamp.com.br
authors.forename: Jose Olympio Meirelles
authors.initials: JO
authors.lastname: Santos
authors.forename: Nelson
authors.initials: N
authors.lastname: Miyajima
authors.forename: Rita
authors.initials: R
authors.lastname: Carvalho
authors.forename: Raquel Franco
authors.initials: RF
authors.lastname: Leal
authors.forename: Maria de Lourdes Setsuko
authors.initials: Mde L
authors.lastname: Ayrizomo
authors.forename: Claudio Saddy Rodrigues
authors.initials: CS
authors.lastname: Coy
mesh_terms: D000368:Aged; D001706:Biopsy; D001938:Brazil; D003110:Colonic Neoplasms / Q000473:pathology / Q000601:surgery*; D004210:Dissection / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005753:Gastric Mucosa / Q000293:injuries / Q000473:pathology / Q000601:surgery*; D006782:Hospitals, Special; D006801:Humans; D007413:Intestinal Mucosa / Q000293:injuries / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D015203:Reproducibility of Results; D013274:Stomach Neoplasms / Q000601:surgery*; D016896:Treatment Outcome