How Is Endoscopic Submucosal Dissection for Gastrointestinal Lesions Being Implemented? Results from an International Survey
Background and Study Aim: Superficial gastrointestinal (GI) neoplasms can be treated with endoscopic mucosal resection (EMR) and/or endoscopic submucosal dissection (ESD). These techniques are widely used in Eastern countries; however, its use in the West is limited. The aim of this study was to eva...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Karger Publishers
2019-09-01
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| Series: | GE: Portuguese Journal of Gastroenterology |
| Subjects: | |
| Online Access: | https://www.karger.com/Article/FullText/501404 |
| _version_ | 1819205669767610368 |
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| author | Miguel Araújo-Martins Pedro Pimentel-Nunes Diogo Libânio Marta Borges-Canha Mário Dinis-Ribeiro |
| author_facet | Miguel Araújo-Martins Pedro Pimentel-Nunes Diogo Libânio Marta Borges-Canha Mário Dinis-Ribeiro |
| author_sort | Miguel Araújo-Martins |
| collection | DOAJ |
| description | Background and Study Aim: Superficial gastrointestinal (GI) neoplasms can be treated with endoscopic mucosal resection (EMR) and/or endoscopic submucosal dissection (ESD). These techniques are widely used in Eastern countries; however, its use in the West is limited. The aim of this study was to evaluate the current implementation of ESD in Western countries. Methods: Western endoscopists (n = 279) who published papers related to EMR/ESD between 2005 and 2017 were asked to complete an online survey from December 2017 to February 2018. Results: A total of 58 endoscopists (21%) completed the survey. Thirty performed ESD in the esophagus (52%), 45 in the stomach (78%), 36 in the colorectum (62%), and 6 in the duodenum (10%). The median total number of lesions ever treated per endoscopist was 190, with a median number per endoscopist in 2016 of 41 (7 [IQR 1–21], 6 [IQR 4–16], and 28 [5–63] in the esophagus, in the stomach, and in the colon and rectum, respectively). En bloc resection rates were 97% in the esophagus, 95% in the stomach, and 84% in the colorectum. Complete resection (R0) was achieved in 88, 91, and 81%, respectively. Curative rates were 69, 70, and 67%, respectively. Major complications (perforation or delayed bleeding) occurred more often in colorectal ESD (12 vs. 6% in the esophagus and 7% in the stomach). In the upper GI tract, the majority of resected lesions were intramucosal adenocarcinoma (59% in the esophagus; 47% in the stomach), while in the colorectum the majority were adenomas (59%). Conclusion: ESD seems to be performed by a large number of centers and endoscopists. Our results suggest that ESD is being successfully implemented in Western countries, achieving a good rate of efficacy and safety according to European guidelines. |
| first_indexed | 2024-12-23T04:55:23Z |
| format | Article |
| id | doaj.art-41b7aa737f8c4bbfbaea6d9f3cee42bb |
| institution | Directory Open Access Journal |
| issn | 2341-4545 2387-1954 |
| language | English |
| last_indexed | 2024-12-23T04:55:23Z |
| publishDate | 2019-09-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | GE: Portuguese Journal of Gastroenterology |
| spelling | doaj.art-41b7aa737f8c4bbfbaea6d9f3cee42bb2022-12-21T17:59:22ZengKarger PublishersGE: Portuguese Journal of Gastroenterology2341-45452387-19542019-09-0111710.1159/000501404501404How Is Endoscopic Submucosal Dissection for Gastrointestinal Lesions Being Implemented? Results from an International SurveyMiguel Araújo-MartinsPedro Pimentel-NunesDiogo LibânioMarta Borges-CanhaMário Dinis-RibeiroBackground and Study Aim: Superficial gastrointestinal (GI) neoplasms can be treated with endoscopic mucosal resection (EMR) and/or endoscopic submucosal dissection (ESD). These techniques are widely used in Eastern countries; however, its use in the West is limited. The aim of this study was to evaluate the current implementation of ESD in Western countries. Methods: Western endoscopists (n = 279) who published papers related to EMR/ESD between 2005 and 2017 were asked to complete an online survey from December 2017 to February 2018. Results: A total of 58 endoscopists (21%) completed the survey. Thirty performed ESD in the esophagus (52%), 45 in the stomach (78%), 36 in the colorectum (62%), and 6 in the duodenum (10%). The median total number of lesions ever treated per endoscopist was 190, with a median number per endoscopist in 2016 of 41 (7 [IQR 1–21], 6 [IQR 4–16], and 28 [5–63] in the esophagus, in the stomach, and in the colon and rectum, respectively). En bloc resection rates were 97% in the esophagus, 95% in the stomach, and 84% in the colorectum. Complete resection (R0) was achieved in 88, 91, and 81%, respectively. Curative rates were 69, 70, and 67%, respectively. Major complications (perforation or delayed bleeding) occurred more often in colorectal ESD (12 vs. 6% in the esophagus and 7% in the stomach). In the upper GI tract, the majority of resected lesions were intramucosal adenocarcinoma (59% in the esophagus; 47% in the stomach), while in the colorectum the majority were adenomas (59%). Conclusion: ESD seems to be performed by a large number of centers and endoscopists. Our results suggest that ESD is being successfully implemented in Western countries, achieving a good rate of efficacy and safety according to European guidelines.https://www.karger.com/Article/FullText/501404Endoscopic submucosal dissectionSurveyGastrointestinal superficial lesions |
| spellingShingle | Miguel Araújo-Martins Pedro Pimentel-Nunes Diogo Libânio Marta Borges-Canha Mário Dinis-Ribeiro How Is Endoscopic Submucosal Dissection for Gastrointestinal Lesions Being Implemented? Results from an International Survey GE: Portuguese Journal of Gastroenterology Endoscopic submucosal dissection Survey Gastrointestinal superficial lesions |
| title | How Is Endoscopic Submucosal Dissection for Gastrointestinal Lesions Being Implemented? Results from an International Survey |
| title_full | How Is Endoscopic Submucosal Dissection for Gastrointestinal Lesions Being Implemented? Results from an International Survey |
| title_fullStr | How Is Endoscopic Submucosal Dissection for Gastrointestinal Lesions Being Implemented? Results from an International Survey |
| title_full_unstemmed | How Is Endoscopic Submucosal Dissection for Gastrointestinal Lesions Being Implemented? Results from an International Survey |
| title_short | How Is Endoscopic Submucosal Dissection for Gastrointestinal Lesions Being Implemented? Results from an International Survey |
| title_sort | how is endoscopic submucosal dissection for gastrointestinal lesions being implemented results from an international survey |
| topic | Endoscopic submucosal dissection Survey Gastrointestinal superficial lesions |
| url | https://www.karger.com/Article/FullText/501404 |
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