Lee WS, Cho JW, Kim YD, Kim KJ, Jang BI. Technical issues and new devices of ESD of early gastric cancer. World J Gastroenterol 2011; 17(31): 3585-3590 [PMID: 21987604 DOI: 10.3748/wjg.v17.i31.3585]
Corresponding Author of This Article
Byung Ik Jang, MD, Division of Gastroenterology, Department of Internal Medicine, Yeungnam University College of Medicine, 317-1, Daemyeong 5-dong, Nam-gu, Daegu 705-717, South Korea. jbi@med.yu.ac.kr
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World J Gastroenterol. Aug 21, 2011; 17(31): 3585-3590 Published online Aug 21, 2011. doi: 10.3748/wjg.v17.i31.3585
Technical issues and new devices of ESD of early gastric cancer
Wan Sik Lee, Jin Woong Cho, Young Dae Kim, Kyu Jong Kim, Byung Ik Jang
Wan Sik Lee, Division of Gastroenterology, Department of Internal Medicine, Chonnam University Medical School, Gwangju 501757, South Korea
Jin Woong Cho, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Presbyterian Medical Center, Jeonju 560750, South Korea
Young Dae Kim, Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Chosun University, Gwangju 501717, South Korea
Kyu Jong Kim, Division of Gastroenterology, Department of Internal Medicine, Kosin University College of Medicine, Busan 602702, South Korea
Byung Ik Jang, Division of Gastroenterology, Department of Internal Medicine, Yeungnam University College of Medicine, Deagu 705717, South Korea
Author contributions: Lee WS drafted the manuscript; Cho JW, Kim YD, and Kim KJ gathered the data; Jang BI reviewed and edited the manuscript.
Correspondence to: Byung Ik Jang, MD, Division of Gastroenterology, Department of Internal Medicine, Yeungnam University College of Medicine, 317-1, Daemyeong 5-dong, Nam-gu, Daegu 705-717, South Korea. jbi@med.yu.ac.kr
Telephone: +82-53-6203830 Fax: +82-53-6548386
Received: December 28, 2010 Revised: May 9, 2011 Accepted: May 16, 2011 Published online: August 21, 2011
Abstract
Endoscopic submucosal dissection (ESD) is a highly refined technique compared to conventional endoscopic mucosal resection. It enables complete resection of early gastric cancer (EGC) which has no possibility of lymph node metastasis. Indication for ESD of EGC generally entails early gastric cancer confined to the mucosa with well differentiated histology, though there are clinically suitable expanded criteria. As ESD requires specific skill and expertise, endoscopists need to be familiarized with basic methods and the use of special devices. The essence of the technique is to dissect the submucosal layer with direct vision and maintain the cutting plane above the underlying proper muscle layer. Although there are some differences in the detailed technical aspect, the cardinal method of ESD is now well established and standardized. Furthermore, research and development of new ESD devices that render more efficient, safe ESD are still in progress to improve the overall result of ESD on early gastric cancer.
