Application of Endoscopic Submucosal Dissection (ESD) in treatment of gastrointestinal lesions- single center experience.

Abstract

IntroductionEndoscopic resection of gastrointestinal tract lesions, originating from Japan, is becoming more frequently used in European countries. Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) ensure minimally invasive removal of benign, premalignant and early neoplastic tumours of esophageus, stomach and intestine in selected group of patients.AimAim of this study was to determine the outcomes, radical resection rate (R0) and complication rate of ESD procedures performed in our department. Material and methodsThe data from 100 ESD procedures of esophageal, gastric, duodenal and colorectal lesions performed in out unit between 02.01.2020 and 30.06.2023 was collected and analysed retrospectively. Results42 male and 58 female patients in the median age of 64 years old (ranging 31 – 89 yo) underwent ESD. Mean duration of the procedure was 66 minutes (ranging 25 – 185 minutes). Tumours were located in oesophagus in 8 cases (8%), stomach in 25 cases (25%), duodenum in 1 case (1%) and colon in 66 cases (66%). Radical resection was achieved in 98 cases (98%) - 2 patients were qualified for surgical treatment Average size of dissection lesions was 26 x 19 mm. The biggest one was 60 x 60 mm (sigmoid adenoma) and smallest one was 5 x 5 mm (GNET). Complication occurred in 10 patients (10%) – 9 perforations of the wall of intestine (9%) and 1 hamorrhage, which required endoscopic intervention (1%). ConclusionsWith proper qualification, ESD is effective and safe method of treatment for benign, premalignant and early neoplastic lesions of gastrointestinal tract in hands of experienced endoscopists. Following current guidelines satisfying outcomes, comparable with leading center, can be achieved.