title: Indications and Techniques for Endoscopic Submucosal Dissection.
abstract: Endoscopic submucosal dissection (ESD) allows for curative resection of superficial neoplasms of the gastrointestinal tract. Although ESD is the standard of care in Japan, its adoption in the West has been slow. Recent studies have shown the advantages of ESD over endoscopic mucosal resection, and as many of the barriers to ESD have been overcome, we are seeing an increasing interest in this technique. ESD can be used to treat superficial gastric, esophageal, and colorectal lesions. The most important pre-procedure step is estimating the depth of invasion of a lesion and by proxy the risk of lymph node metastasis. After a lesion has been resected, the histopathological analysis will determine whether the resection was curative or whether further surgery is needed. In conclusion, ESD is being more widely used in the West, and it is important to understand the indications, limitations, and techniques of ESD.
authors.affiliation: Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Amit
authors.initials: A
authors.lastname: Bhatt
authors.affiliation: Endoscopy Division, National Cancer Center, Hospital, Tokyo, Japan.
authors.forename: Seiichiro
authors.initials: S
authors.lastname: Abe
authors.affiliation: Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Arthi
authors.initials: A
authors.lastname: Kumaravel
authors.affiliation: Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: John
authors.initials: J
authors.lastname: Vargo
authors.affiliation: Endoscopy Division, National Cancer Center, Hospital, Tokyo, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Saito
mesh_terms: D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D004210:Dissection / Q000379:methods*; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery*; D005753:Gastric Mucosa / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology / Q000601:surgery*; D009092:Mucous Membrane / Q000473:pathology / Q000601:surgery; D009361:Neoplasm Invasiveness; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*