title: Advanced endoscopic submucosal dissection with traction.
abstract: Endoscopic submucosal dissection (ESD) has been established as a standard treatment for early stage gastric cancer (EGC) in Japan and has spread worldwide. ESD has been used not only for EGC but also for early esophageal and colonic cancers. However, ESD is associated with several adverse events, such as bleeding and perforation, which requires more skill. Adequate tissue tension and clear visibility of the tissue to be dissected are important for effective and safe dissection. Many ESD methods using traction have been developed, such as clip-with-line method, percutaneous traction method, sinker-assisted method, magnetic anchor method, external forceps method, internal-traction method, double-channel-scope method, outerroute method, double-scope method, endoscopic-surgical-platform, and robot-assisted method. Each method has both advantages and disadvantages. Robotic endoscopy, enabling ESD with a traction method, will become more common due to advances in technology. In the near future, simple, noninvasive, and effective ESD using traction is expected to be developed and become established as a worldwide standard treatment for superficial gastrointestinal neoplasias.
authors.affiliation: Hiroyuki Imaeda, Department of General Internal Medicine, Saitama Medical University, Saitama 350-0495, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Imaeda
authors.affiliation: Hiroyuki Imaeda, Department of General Internal Medicine, Saitama Medical University, Saitama 350-0495, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Hosoe
authors.affiliation: Hiroyuki Imaeda, Department of General Internal Medicine, Saitama Medical University, Saitama 350-0495, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Kashiwagi
authors.affiliation: Hiroyuki Imaeda, Department of General Internal Medicine, Saitama Medical University, Saitama 350-0495, Japan.
authors.forename: Tai
authors.initials: T
authors.lastname: Ohmori
authors.affiliation: Hiroyuki Imaeda, Department of General Internal Medicine, Saitama Medical University, Saitama 350-0495, Japan.
authors.forename: Naohisa
authors.initials: N
authors.lastname: Yahagi
authors.affiliation: Hiroyuki Imaeda, Department of General Internal Medicine, Saitama Medical University, Saitama 350-0495, Japan.
authors.forename: Takanori
authors.initials: T
authors.lastname: Kanai
authors.affiliation: Hiroyuki Imaeda, Department of General Internal Medicine, Saitama Medical University, Saitama 350-0495, Japan.
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Ogata
keywords: Early colonic cancer; Early esophageal cancer; Early gastric cancer; Endoscopic submucosal dissection; Traction