title: [Single centre experience of endoscopic submucosal dissection (ESD) in premalignant and malignant gastrointestinal neoplasia].
abstract: BACKGROUND
  Worldwide endoscopic submucosal dissection (ESD) of early GI cancers or premalignant neoplasia is becoming increasingly important. In Germany ESD is restricted to larger endoscopic institutions and only a few literature reports are available. The aim of the present study is to describe the results of 46 ESDs conducted in a German endoscopic centre.
  
  
  METHODS
  Between June 2007 and May 2012 46 ESDs in 45 patients (33 men, 12 women, mean age 66.1 years) were performed in the oesophagus (n = 17), stomach (n = 23) and rectum (n = 6). Data were collected for the en-bloc, R0 and R0 en-bloc resection rates as well as for complications, the curative resection and the local recurrence rates. In order to demonstrate a learning curve, results were evaluated for two periods (June 2007 to November 2010 vs. December 2010 to May 2012).
  
  
  RESULTS
  ESD was technically possible in 93.5%. En-bloc, R0, R0 en-bloc and curative resection rates were 90.7%, 74.4%, 67.4% and 65.1%, respectively. The complication rate was 13%. In the second period en-bloc and R0 en-bloc resection rates increased from 81% to 100% and, respectively, from 52.4% to 81.8%. After a medium follow-up of 11.4 months, local tumour recurrence occurred in 10%. In cases of curative R0 en bloc resection of malignant tumours no tumour recurrence occurred.
  
  
  CONCLUSIONS
  Despite the small number of patients, the present data underline the value of ESD, especially in cases of R0 en-bloc resections in the therapy for premalignant and early malignant GI tumours. Due to the required learning curve, ESD should be restricted to larger endoscopic centres in Germany.
authors: Gastroenterolgie & Hepatologie, Asklepios Klinik Barmbek, Hamburg.
authors: S
authors: S
authors: Höbel
authors: Gastroenterolgie & Hepatologie, Asklepios Klinik Barmbek, Hamburg.
authors: R
authors: R
authors: Baumbach
authors: Gastroenterolgie & Hepatologie, Asklepios Klinik Barmbek, Hamburg.
authors: P
authors: P
authors: Dautel
authors: Viszeralchirurgie, Asklepios Klinik Barmbek, Hamburg.
authors: K J
authors: KJ
authors: Oldhafer
authors: Onkologie & Palliativmedizin, Asklepios Klinik Barmbek, Hamburg.
authors: A
authors: A
authors: Stang
authors: MVZ Hanse Histologikum GmbH, Hamburg.
authors: B
authors: B
authors: Feyerabend
authors: Division of Research and Development for Minor Invasive Treatment, Tumor Center, Keio University School of Medicine, Tokyo.
authors: N
authors: N
authors: Yahagi
authors: Gastroenterolgie & Hepatologie, Asklepios Klinik Barmbek, Hamburg.
authors: S
authors: S
authors: Faiss
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016145:Endoscopy, Digestive System / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000473:pathology* / Q000601:surgery*; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000517:prevention & control*; D016896:Treatment Outcome; D055815:Young Adult